Infection in postoperative patients.

The majority of surgical infections are due to multiple bacterial pathogens, usually represented by mixtures of both aerobic and anaerobic species. Contamination from endogenous sources accounts for the majority of these infections. The most virulent of all such sepsis appears to arise from a symbiosis between aerobic gram-negative rods and various anaerobes. Antibiotics have proved efficacy in both the treatment as well as the prevention of surgical infection. The choice of antimicrobial agent(s) should be based upon the drug's spectrum of activity against known or anticipated pathogens, the biologic half-life of the agent, which serves as a guide to the frequency of administration, and the drug's safety. The third-generation cephalosporins have been shown to be especially useful because of their broad spectrum of activity, prolonged half-life, and limited toxicity. Sepsis that persists or is uncontrolled despite antibiotic administration often leads to failure of multiple organ systems. Only energetic surgical measures offer any real chance for patient survival when such a stage has been reached.