[3] Even when sterile techniques are adhered to, surgical procedures can introduce bacteria and other microbes in the blood (causing bacteremia), which can colonize and infect different parts of the body.
[citation needed] Worldwide experience with antimicrobial prophylaxis in surgery has proven to be effective and cost-efficient, both avoiding severe patient suffering while saving lives (provided the appropriate antibiotics have been carefully chosen and used to the best of current medical knowledge).
Drugs should be selected with a reasonable spectrum of activity against pathogens likely to be encountered, and antibiotics should be chosen with kinetics that will ensure adequate serum and tissue levels throughout the risk period.
Depending on the type of surgery and anticipated contamination associated with it, combinations of different agents or different routes of administration (e.g. intravenous and oral antibiotics) might be beneficial in reducing perioperative adverse events.
[citation needed] The American Heart Association (AHA) now recommends antibiotic prophylaxis for very few patients since only a small number of cases of endocarditis might be prevented by this procedure.
[13] The Auditor General of Canada found lack of progress in 2014 on antimicrobial resistance despite three years of government funds that should have been used to implement a reduction programme.
"[13] Due to the serious problem of superbugs (which are bred in antibiotic-rich environments) the Food and Drug Administration issued a guidance document in December 2013.
The chief public health officer of Canada said four months later that "antibiotics should only be used in animals to treat infection rather than guard against disease or promote growth."
The Canadian guidance document calls for "the prudent use of antibiotics in animal agriculture and a gradual phasing out of growth promoting drugs in feed and water over the three years" ending in 2017.