Basic principles in the use of prophylactic antibiotics.

The prophylactic administration of antibiotic to the surgical patient is generally indicated whenever complicating infection of the incision or coelom to be violated is associated with a significant morbidity and/or mortality rate. For maximal benefit, antibiotic must be in the tissues at risk just prior to and throughout the entire period of bacterial contamination. When a parenteral route for delivery is uncertain, as in the case of shock or a burn wound, then topical application becomes a practical alternative. Only hospital surveillance, however, can dictate which patients and which surgical procedures warrant prophylactic antibiotic. Intelligently implemented, such a preventive programme can reduce significantly total expenditure for surgical health care.