Antibacterial prophylaxis of surgical site infections in oral surgery: not only and not always systemic antibiotics

Antibacterial prophylaxis is a set of treatment measures, including antibiotic prophylaxis, under surgeon’s responsibility. If local measures are always to be applied, antibiotic prophylaxis administration needs a careful case selection in order to avoid indiscriminate prescription. Local measures include the following: use of sterile instrumentation and special devices to prevent surgical site contamination; good surgical treatment; pre-surgical treatment of acute local infections; pre-surgical calculus removal and perioperative plaque control; post-surgical follow-up. Antibiotic prophylaxis should follow the following five basic principles: only procedures that have high risk of infection need antibiotic prophylaxis; an adequate antibiotic should be chosen; a high dose of antibiotic should be used; the time of administration should be correct; antibiotic activity should be as short as possible.