Without antibiotics, many medical procedures and treatments we take for granted—hip replacement, pacemaker insertion, appendectomies, and some types of cancer chemotherapy, to name a few—would become more problematic. In fact, the chance of infection from these interventions is so high that they’d be risky if antibiotics weren’t given preventively beforehand. Now, new research suggests that antibiotics may no longer be as effective at preventing these infections.

The report, published in the journal The Lancet Infectious Diseases, looked at more than 30 studies and meta analyses (research papers that analyze the results of multiple studies) on antibiotic use and infection rates for 10 common procedures where preventive antibiotic use is routine and appropriate. They also examined infection data. The researchers estimate that up to half of surgical infections and 25 percent of infections that occur in people receiving chemotherapy are resistant to the antibiotics that are commonly used preventively. What’s more, they calculated that if the drugs became just 30 percent less effective at preventing infection, 120,000 more infections and 6,300 more deaths would occur in the U.S. each year. 

"This study gives us a new perspective on antibiotic resistance,” says Joshua Wolf, an infectious disease physician at St. Jude Children’s Research Hospital who wrote an editorial accompanying the study.

Wolf explains that using antibiotics before treatment for prevention purposes isn’t the same as using an antibiotic just in case your sore throat turns out to be strep.

“The consequences of not being able to prevent these kinds of infections are serious; they take a long time to treat or may even be untreatable,” he says.

For example, chemotherapy for leukemia in children has dramatically increased survival rates. But the treatment suppresses the immune system, so it raises infection risk.

“We need antibiotics to work because we can’t cure leukemia without the chemotherapy,” he says. “It’s devastating when someone who would otherwise survive cancer dies of an infection.”  

“Both physicians and consumers should do what they can to reduce the inappropriate use of antibiotics, so they work at the times we need them most” says Wolf. For consumers, that includes not pushing your doctor for antibiotics if he or she says the infection isn’t bacterial and buying no-antibiotic meat and poultry. And if you are having surgery or chemotherapy, take these three steps: 

Antibiotic Rules

  • Talk to your doctor about the drugs. Antibiotics aren’t appropriate before all types of surgery or chemotherapy. Ask if you really need them, and if you do, mention that if possible you’d like an antibiotic that targets the specific bacteria likely to cause problems, rather than a broad-spectrum antibiotic that kills many types of bacteria.
  • Ask about MRSA screening. If you test negative for MRSA (methicillin-resistant staphylococcus aureus) you may not need antibiotics for some procedures.
  • Do not take antibiotics longer than necessary. For most surgeries, these drugs should be discontinued within 24 hours; 48 hours for heart surgery. If you aren’t feeling up to it, ask a friend or relative who will be with you in the hospital to check with the medical staff.