Prophylactic antibiotic therapy in surgery

Prophylactic (preventive) antibiotic therapy initiated preoperatively, with antibiotics administered in moderately high dosage for short periods, is recommended on the basis of experimental and prospective, randomized clinical trials for patients who require surgery that is likely to expose tissue planes to contamination. The value of prophylactic antibiotics in clean operations is not presently supported but must be considered in patients with decreased resistance and in those in whom infection of a prosthesis would have catastrophic results. In these patients topical antibiotics might prove useful and less dangerous. It is clear that surgical technique remains an important but as yet unmeasured factor in wound infection.