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June 19, 1981

Management of Surgical Infections

Author Affiliations

Rancho Los Amigos Hospital Downey, Calif

JAMA. 1981;245(23):2449-2453. doi:10.1001/jama.1981.03310480061037

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This book dealing with surgical infections is limited in its depth and scope, dealing with gastrointestinal infections, vascular graft infections, endocarditis, mediastinal infections, and nosocomial infections. There are introductory chapters on hospital epidemiology, host defenses, and clinical microbiology. In a book with this title we might have expected to see many chapters on infections that surgeons must manage.

There is one chapter that seems to be misplaced: "Anaerobes and Intra-Abdominal Infections: A Skeptic's Viewpoint." After reviewing the limited evidence that Bacteroides fragilis may not be a pathogen in experimental and clinical studies, the author concluded, "Additional evidence is necessary before the risk and cost of anaerobic-directed antibiotic therapy can be justified. The positive blood culture for B fragilis in the patient with intra-abdominal infection should properly be viewed as an indication for laparotomy and not as an indication for additional unproven antibiotic treatment." The author seems to ignore an extensive