[Prophylactic use of antibiotics (author's transl)]

The correlation between extensive aminoglycoside usage and the resistance of P. aeruginosa and Enterobacteriaceae (up to 40%) is a particularly striking aspect in hospitals. Favourable conditions for an effective prophylaxis are the limitation to one pathogen, a defined location and recent contamination. In so-called "clean" operations, prophylaxis is reasonably justified in exceptional cases only. Likewise, no benefit is to be expected from chemoprophylaxis in most of the so-called "clean-contaminated" surgical procedures. In septic surgery, antibiotic prophylaxis is indicated even if effectiveness is limited. Indiscriminate routine use, longterm treatment and local application of antibiotics to intensely contaminated areas is definitely not to be recommended.