Pros and cons of antimicrobial prophylaxis in surgery

Careful animal studies have demonstrated the scientific rationale for perioperative antimicrobial therapy in selected operations in order to prevent infectious complications. Operative procedures that carry increased risk for the patients or in which the results of infection are devastating, should now be carried out concomitantly with antimicrobial prophylaxis. Several studies have shown that therapy must begin before bacteria can establish themselves in the operative field and need not be continued for more than 24 hours. These principles should now be implemented in surgical practice with careful ongoing surveillance of infection, incidence and antimicrobial use to ensure their continuing efficacy.