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November 1982

Antibiotics and Colon Surgery-Reply

Arch Surg. 1982;117(11):1499. doi:10.1001/archsurg.1982.01380350085013

In Reply.—I confess that I fail to discern a substantive disagreement between Dr Menaker's practices and the position advocated in the editorial. Dr Menaker administers intravenous (IV) ampicillin, a cephalosporin, or chloramphenicol intraoperatively and postoperatively to his patients undergoing colorectal operations; in six of the 100 patients he described a wound infection developed.1

Whether antibiotics should be administered parenterally or orally is one of the open, lively issues of current surgical discussion identified in the editorial. But the major editorial point was that the evidence from numerous controlled clinical studies was now sufficiently clear that all patients having a colorectal operation today should receive antibiotics by one route or another. The evidence in favor of antibiotics is so overwhelming that, in my view, this is no longer a moot issue.2

While I share Dr Menaker's general concern about our current medicolegal climate, in my mind that climate

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