Journal watch1 April 2026
Author(s): F. Allerton, T.M. Sorensen, K. Scahill, F. Swinbourne, D.R. Verwilghen, M.C. Nolff, F. Foroutan, S.J. Baines, A. Vilen, E.M. Broens, P.L. Toutain, M.L. Brennan, T. Mooney, S. Clarke, J.E. Miles, J.L. Granick, L.R. Jessen, J.S. Weese
Published in: Journal of Small Animal Practice
Date: December 2025
DOI: https://doi.org/10.1111/jsap.70072
Type of access: Open access (click for full article)
Our summary
The aim of these guidelines was to offer guidance to veterinary practitioners on the use of surgical antimicrobial prophylaxis (SAP) for soft tissue and orthopaedic surgical procedures in dogs and cats. They are based on the available literature, which was reviewed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach to assess the certainty of evidence and to draft recommendations. The guideline panel, which represented a wide range of veterinary clinical fields prioritised clinical questions and generated by the guideline panel in an iterative process of Delphi questionnaires and online meetings.
Structured interviews were conducted with veterinary practitioners across Europe to ensure the relevance of the guidelines and to integrate the perspectives of guideline end-users.
The guidelines are presented as a list of 18 recommendations regarding peri-operative and post-operative (referring to administration 24 hours after procedure) antimicrobial use based on level of contamination for different types of surgical procedures. They each receive a corresponding level of certainty, elaborated upon in a section discussing the available evidence for each recommendation. The procedures considered were: neutering, clean soft tissue procedures, clean-contaminated soft tissue procedures (urological, gastrointestinal, and others), contaminated soft tissue procedures, clean orthopaedic surgical procedures not involving the placement of an implant, and clean orthopaedic procedures that do involve the placement of an implant.
Peri-operative SAP was recommended in the following situations: urological procedures with suspected active infections, clean-contaminated gastrointestinal surgical procedures (except those involving the stomach alone), contaminated soft tissue procedures, as well as clean orthopaedic procedures involving the placement of an implant. Post-operative SAP was only recommended in one instance, for surgeries re-classified as contaminated during the procedure, following events such as gastrointestinal spillage. Otherwise, peri-operative and post-operative SAP were recommended against for all other procedures listed. Most of the 18 recommendations were labelled as very low certainty, with the most relevant evidence available for neutering procedures and for post-operative SAP following orthopaedic procedures involving the placement of an implant.
The guidelines also include a section on the administration of SAP, with general guidance on agent selection, dosing regimens, prophylaxis approach in patients already receiving antimicrobials, and adaptations according to procedure duration.
Limitations to the guidelines include a lack of existing RCTs and observational trials on the efficacy of SAP, which downgrade the evidence used for the recommendations. The guidelines also limit their focus to veterinary practitioners, not evaluating the views of veterinary technicians and nurses or the perspectives of pet owners.
Take home
These guidelines provide guidance on the use of SAP for different surgical procedures in dogs and cats. Peri-operative SAP is recommended in clean-contaminated gastrointestinal procedures, urological procedures with suspected active infection, contaminated soft-tissue procedures, and orthopaedic procedures involving the placement of implants. Post-operative SAP is generally recommended against, except in cases of contaminated soft-tissue procedures.
The following may also be of interest
Evidence collection: Responsible use of antibiotics in veterinary practice. [RCVS Knowledge] [Online] Available from: https://www.rcvsknowledge.org/resource/responsible-use-of-antibiotics-in-veterinary-practice/ [Accessed 1 April 2026]
PROTECT ME. Responsible antibacterial use in the veterinary community. [BSAVA] [Online] Available from: https://www.bsava.com/Resources/Veterinary-resources/PROTECT-ME/ [Accessed 1 April 2026]
Journal watch: Placebo is non-inferior to postoperative antimicrobial treatment in uncomplicated canine pyometra – A double-blinded randomized controlled trial. [RCVS Knowledge] [Online] Available from: https://www.rcvsknowledge.org/resource/placebo-is-non-inferior-to-postoperative-antimicrobial-treatment-in-uncomplicated-canine-pyometra-a-double-blinded-randomized-controlled-trial/ [Accessed 1 April2026]
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