The use of antibiotics in the prevention of post-operative infection: a re-appraisal.

The use of antibiotics to prevent infection is a contentious issue in all surgical specialties. Ideally, antibiotic administration should reduce morbidity and mortality. In reality, they may cause drug interactions, allergic and other untoward reactions, and reduce colonisation resistance; this can result in infections with resistant microorganisms. Therefore, when used injudiciously, the patient may suffer more than if antibiotics had not been prescribed. The most effective use of prophylactic antibiotics has been shown to be in short term, high dosage regimens that are active against the common pathogens. To achieve any protective effect, antibiotics must be administered pre-operatively to provide adequate tissue concentrations at the time of surgery.