Opportunities for system level improvement in antibiotic use across the surgical pathway

•Optimizing antibiotic prescribing across the surgical pathway is key to tackling the important drivers antimicrobial resistance.•Evidence from around the world indicates that antibiotics for surgical prophylaxis are administered ineffectively.•Much of the evidence in infection management in surgery is related to infection prevention and control, surgical prophylaxis and the management of surgical site infections.•This article provides an overview of the surgical pathway and considers infection management and antibiotic prescribing at each step of the pathway.