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June 1985

An Inaccurate Review of Antibiotic Prophylaxis-Reply

Author Affiliations

San Francisco

Arch Surg. 1985;120(6):755. doi:10.1001/archsurg.1985.01390300092019

In Reply.—Dr Miller has stated that our review analyzed "incomplete data containing many elementary errors of clinical discrimination, definition, and presentation." Several comments are warranted in response to this criticism.

Regarding the first article, by Ericson et al,1 there was a statistically significant reduction in postoperative infection in those patients receiving prophylactic antibiotics. Furthermore, when one looks specifically at the 118 Charnley total hip replacement cases, the effect of prophylaxis is evident. It is not surprising that there was no significant antibiotic effect in cases involving internal fixation or prostheses, considering the numbers of patients enrolled in these subcategories. Only 39 patients with pertrochanteric fractures and 14 patients with Moore prostheses participated in the study, numbers far too few to yield meaningful data.

Miller criticized the second article2 and fifth article,3 respectively, because the investigators did not include infected hematomas in their postoperative wound-infection categories. Contrary

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