New Therapeutic Guidelines on Antimicrobial Prophylaxis were published on the 29th January which were developed jointly by the American Society of Health-System Pharmacists (ASHP), the Infectious Diseases Society of America (IDSA), the Surgical Infection Society (SIS), and the Society for Healthcare Epidemiology of America (SHEA). This work represents an update to the previously published ASHP Therapeutic Guidelines on Antimicrobial Prophylaxis in Surgery, as well as guidelines from IDSA and SIS. The guidelines provide practitioners with a standardised approach to the safe, and effective use of antimicrobial agents for the prevention of surgical-site infections (SSIs) based on currently available clinical evidence. The new guidelines recommend that nasal decolonisation of all patients with documented colonisation with S. aureus and not just MRSA should be common practice. This is a significant shift in the advice, as previously only MRSA colonisation was advocated. Dr Bill Love, CEO of Destiny Pharma said “These new guidelines recognise that many more patients are at risk from S. aureus during surgery and that decolonisation can effectively reduce this risk. With widespread adoption of this best surgical practice, antibiotic resistance pressure on existing antibiotics will intensify – highlighting the need for new drugs to deliver, long-term, this highly cost effective intervention”.