Antibiotics--their administration, choice and prophylactic use

A wider range of antibiotics is now available with the advent of two new cephalosporins--cefamandole and cefuroxime, and the first cephamycin--cefoxitin. These drugs may be particularly useful in the treatment of septicaemia, and when combined with ticarcillin are effective against nearly all pathogens. Cefuroxime can be given intramuscularly. Intravenous cotrimoxazole must be given in large doses to achieve therapeutic concentrations in the cerebrospinal fluid. The correct use of antibiotics for prophylaxis demands an accurate knowledge of the organisms likely to cause infection and the most efficient way of using the antibiotics to prevent that infection. There is little argument about the need for prophylaxis to prevent recurrent rheumatic heart disease or tetanus from a contaminated wound. However, in the various areas of surgery a wide range of antibiotics is used not always as a result of controlled trials having proved their value. Non-surgical situations for prophylaxis are briefly reviewed.