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June 1985

An Inaccurate Review of Antibiotic Prophylaxis

Arch Surg. 1985;120(6):754-755. doi:10.1001/archsurg.1985.01390300092018

To the Editor.—In "Antibiotic Prophylaxis in Surgical Procedures,"1 Guglielmo et al analyzed incomplete data that contained many elementary errors of clinical discrimination, definition, and presentation. The authors reviewed all articles in English that met six important criteria. Seven articles involving orthopedic surgery met these criteria. One2 of the seven articles compared antibiotics in prophylaxis. The other six reported a statistically significant (P<.05) reduction in the rate of postoperative wound infection (PWI) by the use of prophylactic antibiotics.

The first article3 analyzed total hip replacements and hip-fracture surgery. Symbols in a table demonstrated that there was no statistically significant difference in the rate of PWI in the internal fixation and prostheses cases in the control and antibiotictreated groups.

The second article4 presented values that showed no statistically significant reduction in the rate of PWI in hipfracture surgery (nailing or prostheses) by the use of prophylactic

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