Despite use of the best surgical techniques, some operations still carry a high risk of wound infection. Basic and clinical studies have shown that this risk can be reduced by the administration of prophylactic antibiotics. There are certain inherent risks associated with the use of these agents, however, such as toxic and allergic reactions, emergence of resistant bacteria, drug interactions, and superinfections. Moreover, prophylactic antibiotics do not prevent all postoperative infections. For these reasons, their use should be based on an understanding of certain basic principles. This article reviews these principles and discusses their application in specific clinical situations.
Principles of prophylactic antibiotics
Antibiotic prophylaxis has been defined as the preoperative use of antibiotics to prevent infection. Prophylactic use of antibiotics is in contradistinction to the therapeutic use of antibiotics, which are given to treat an already existing infection. Not only are the purposes different but also the manner in which the drugs should be administered for an optimum effect are different. A review of the literature clearly indicates that, in many instances, antibiotics are given postoperatively rather than preoperatively, although it is still referred to as a prophylactic procedure. This difference must be taken into consideration when evaluating the conclusions that are reached and the