Antibacterial prophylaxis--a clinician's view

The principles of antibacterial prophylaxis and its advantages and disadvantages are reviewed. Controlled trials have shown chemoprophylaxis to be beneficial notably in preventing recurrences of rheumatic carditis and urinary infections and in controlling sepsis after cardiac and hip joint surgery and mid thigh amputations. The recently introduced metronidazole prophylaxis for gastrointestinal and gynaecological operations appears highly effective. The use of prophylaxis is briefly discussed in other situations where its value is less certain or where, in the author's opinion, it is contraindicated.