The use of antibiotics on a preventive basis in surgical patients remains controversial and is presently being subjected to the closest scrutiny. Among the dangers of such use, critics cite adverse bacterial floral changes and the toxicity of the drugs themselves.1 These critics rarely find evidence supporting the value of prophylactic use. Such information exists, however, in many excellent studies that should be evaluated before either the individual practitioner or a governmental agency can make a decision regarding the appropriate limitations on the prophylactic use of antibiotics.
Experimental studies in the laboratory have defined certain principles that can maximize the antimicrobial effect of antibiotics used perioperatively. It has been demonstrated that maximal suppression of infection can be achieved when the antibiotic is given in a large dose preoperatively and intraoperatively.2 No effect was seen, however, when the antibiotic was given several hours after the intraoperative bacterial inoculations.
Ketcham AS, Beazley R, Bagley D. Systemic Prophylactic Antibiotics in Surgical Patients. JAMA. 1974;229(12):1638–1639. doi:10.1001/jama.1974.03230500056031
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