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June 27, 1980

Pseudomembranous Colitis

JAMA. 1980;243(24):2484. doi:10.1001/jama.1980.03300500012010

To the Editor.—  I was somewhat disturbed by the conclusions drawn by Tan et al (242:749, 1979) with regard to the prophylactic use of antibiotics. Indeed cephalosporin usage in producing pseudomembranous colitis is rare.1 In their case they present a 67-year-old healthy woman who underwent a vaginal hysterectomy receiving prophylactic cephaloridine before and for three full days after her surgery. When this patient unfortunately died of pseudomembranous colitis, the authors stated that their case illustrates why there is a need for a serious reassessment of the use of prophylactic antibiotics in surgical procedures. I disagree. A prospective study done as early as 19752 clearly indicates that correct antibiotic prophylaxis for vaginal hysterectomy consists of the particular antibiotic available to the operating room and only two subsequent doses postoperatively. Continuing prophylactic antibiotic therapy beyond this is of no value. This was again demonstrated by Ledger et al3 in