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Classen et al18 performed a retrospective study of ap-proximately 3,000 patients undergoing various surgical procedures. The group of patients that received antimi-crobial prophylaxis 1 hour before incision had the lowest rates of SSIs.Evidence suggests that effective prevention of SSIs is achieved through implementation of prophylactic anti-64 AANA Journal n February 2015 n Vol. 83, No. 1 www.aana.com/aanajournalonlineSurgical procedureAppropriate antibioticCardiothoracic and vascular surgery Cefazolin, cefuroxime, or vancomycin If β-lactam allergy: vancomycin or clindamycinHysterectomy Cefotetan, cefazolin, cefoxitin, cefuroxime, or ampicillin/sulbactam If β-lactam allergy: clindamycin + gentamycin (or ciprofloxacin or aztreonam) or metronidazole + gentamicin (or ciprofloxacin) or clindamycin monotherapyHip or knee arthroplasty Cefazolin or cefuroximeIf β-lactam allergy: vancomycin or clindamycinColon Cefotetan, cefoxitin, cefazolin + metronidazole, or ampicillin/sulbactam If β-lactam allergy: clindamycin + gentamycin (or ciprofloxacin or aztreonam) or metronidazole + gentamicin (or ciprofloxacin)Table. Surgical Care Improvement Project Guidelines for Appropriate Antibiotic Selection for Selected ProceduresAbbreviation: +, plus.(Adapted from Bratzler et al23)biotic guidelines to reduce the presence of microorgan-isms during the operative procedure.6,9,14,19 A consensusdistinguishes timely antibiotic prophylaxis as essential in infection prevention, suggesting 30 minutes to 1 hour before incision as the ideal window for drug administra-tion.9,20 Merollini and colleagues20 determined through structured interviews with infectious disease physicians and orthopedic surgeons that antimicrobial prophylaxis is a relevant clinical practice for SSI prevention recom-mended by all participants. Uçkay et al9 conducted a comprehensive literature search using National Library of Medicine Medical Subject Headings (MeSH) terms infection, orthopedic, and prevention. They identified peer-reviewed literature, which revealed that antibi-otic prophylaxis for patients undergoing orthopedic joint surgery, when administered within 30 to 60 minutes before incision, helps to reduce SSI rates to 1% to 3% compared with 4% to 8% without preoperative antibiotic administration.9Based on published evidence, the SCIP established thatan antibiotic received prophylactically within 1 hour before incision reduces the risk of infection.6,16,18,21,22