To the Editor.—The article by Burdon et al, in the Archives (112:1169-1173, 1977) bears careful examination before reaching any conclusions.
The efficacy of preoperative antibiotic administration for the prophylaxis of wound infection has been previously documented by Alexander et al,1 and others.2 This benefit is dependent on the presence of sufficient concentration of antibiotic in the tissue at the time of contamination or injury. It has been found that after the parenteral administration of cephalosporin-type antibiotics, peak tissue concentration is achieved in approximately one hour.3
Dr Burdon's protocol indicates that the first dose of antibiotic was administered at the induction of anesthetic. Even if no vasoconstriction or hypotension were to occur, there is still insufficient time for the antibiotic to achieve good tissue concentration in his study protocol.
Experimental wound infection studies indicate that for effective prophylaxis of experimentally induced wound infection, the antibiotic must be
SLADE MS. Efficacy of Preoperative Antibiotic Therapy in Wound Infection. Arch Surg. 1978;113(8):1015. doi:10.1001/archsurg.1978.01370200109024