Which statement reflects the rationale behind antimicrobial stewardship in the perioperative period?

• A. Maximize Antibiotic Breadth.
• B. Selecting Appropriate Agents, Dosing, and Duration to Prevent Resistance and Adverse Effects While Maintaining Prophylaxis Effectiveness.
• C. Eliminating Antibiotics Entirely.
• D. Reducing Monitoring to Save Time.

Answer: (B)

Perioperative antimicrobial stewardship aims to protect the patient from infection while minimizing harm from antibiotics. The best statement captures this balance: choose the right agent, dose, and duration to maintain effective prophylaxis while reducing the risk of resistance and adverse effects. In practice, this means tailoring the antibiotic to the procedure and likely organisms, using the appropriate narrow spectrum when possible, dosing appropriately for the patient’s size and kidney function, administering at the correct time so tissue levels are adequate at incision, and limiting the duration to the shortest effective period. This approach prevents overuse that drives resistance and toxicity, and avoids underuse that could lead to surgical-site infections.

Options that push for broader coverage, no antibiotics at all, or minimal monitoring don’t align with stewardship. Broad-spectrum use increases resistance and adverse events; skipping antibiotics entirely would risk infection; insufficient monitoring can allow misuse or missed adverse effects. The core idea is maintaining effective prophylaxis with the least harm through thoughtful agent selection, dosing, and duration.