Antibiotic Selection and Redosing to Prevent Surgical Site Infections—When Timing Is Not Enough

Surgical site infections (SSIs) remain among the most common and costly complications following surgery, despite decades of quality improvement efforts.In this context, the multicenter cohort study by Bardia et al 1 provides timely and compelling evidence that current perioperative antibiotic quality metrics may now be misaligned with the practices that most meaningfully influence infection risk.Using linked data from the Multicenter Perioperative Outcomes Group, the National Surgical Quality Improvement Program, and the Michigan Surgical Quality Collaborative, the authors evaluated more than 119 000 noncardiac surgical cases across 37 US institutions.They examined adherence to 4 components of the Infectious Diseases Society of America (IDSA) perioperative antibiotic prophylaxis guidelines: (1) antibiotic selection, (2) weight-based dosing, (3) timing of administration, and (4) intraoperative redosing.1,2 Their findings expose a critical gap between