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October 7, 1983

Prophylactic Antibiotics

Author Affiliations

Oklahoma City

JAMA. 1983;250(13):1693. doi:10.1001/jama.1983.03340130023010

To the Editor.—  Dr Scheckler is to be commended for his recent EDITORIAL (1983;248:1328) in which he stresses the importance of "both scientifically rational and cost-effective data on which to base decisions about surgical antimicrobial prophylaxis." I would like to go a step further and suggest more forethought before using any prophylactic antibiotics. Although infections are common to all specialties, each has its specific problems and concerns. I specialize in orthopedics and can address the status of prophylactic antibiotics specifically.Postoperative wound infections in orthopedic surgery vary from the inconsequential to the disastrous. Failure to categorize this difference has led to much confusion in the literature. Fogelberg and associates1 inadvertently imply this when they state that the rate of postoperative infections requiring surgical drainage was not significantly different in their antibiotic-treated and control group. The data in a frequently quoted article by Boyd and co-workers2 actually show no statistically