Does prophylactic antibiotic use reduce the incidence of wound infection in patients undergoing surgical procedures?
This review highlights the specific surgical procedures where antibiotic prophylaxis is effective or justified, while noting areas with conflicting or insufficient data.
The use of prophylactic antibiotics in surgery is widespread and often inappropriate. The lack of well-designed clinical studies partially explains the present confusion regarding the subject. We reviewed the literature in English on antibiotic prophylaxis through June 1982. Antibiotic prophylaxis reduces the incidence of wound infection after colorectal surgery, vaginal hysterectomy, and laryngeal and oropharyngeal resection for carcinoma, and in high-risk patients undergoing gastroduodenal or biliary surgery. In clean operations such as cardiac surgery, vascular procedures, and orthopedic surgery with placement of prostheses, the high morbidity associated with an infection justifies the use of antibiotics even though the risk of infection is small. There are conflicting data on the usefulness of prophylaxis in abdominal hysterectomy, cesarean section, noncardiac thoracic procedures, and urologic surgery. The effectiveness of prophylaxis in neurosurgery cannot be evaluated at the present time.
B. Joseph Guglielmo (Mon,) studied this question.