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August 1978

Efficacy of Preoperative Antibiotic Therapy in Wound Infection-Reply

Author Affiliations

Oxford, England

Arch Surg. 1978;113(8):1015. doi:10.1001/archsurg.1978.01370200109025

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In Response.—I read with interest the invited editorial comment of Hiram Polk and cannot take issue with him over the problems he has raised concerning our study. However, in answer to his first point that it was inappropriate to include patients undergoing colostomy or colostomy closure, I should mention only that such patients were evenly distributed over both groups. As regards his second point concerning the regrowth of surviving clones of bacteria after the preoperative and peroperative use of antibiotics, this would seem to be a valid suggestion but does not get away from the numbers game which is surely to reduce the level of contaminating bacteria to a level that can be dealt with by the host's own defenses. Thus, the less the contamination, the less antibiotic needed for protection. The third point may be true too but there is not adequate data, I believe, about the use

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