Antimicrobial prophylaxis: a critique of recent trials.

J. V. Hirschmann, Thomas Inui

Research output: Contribution to journalArticle

131 Citations (Scopus)

Abstract

Most evaluations of antimicrobial prophylaxis have serious defects in design or fail to assess the clinical importance of observed differences. Reports that were published in the last decade and that meet stringent criteria indicate that antimicrobial prophylaxis is justified in few circumstances and nearly always only in very short courses, often just a single dose. These situations include vaginal hysterectomies (cephalosporin or penicillin), total abdominal hysterectomies (cephalosporin), high-risk cesarean sections (cephalosporin), elective colorectal surgery (oral erythromycin-neomycin, kanamycin-metronidazole, or doxycycline), vascular grafts of the abdominal aorta or lower extremity vasculature (cephalosporin), total hip replacement (cephalosporin or penicillinase-resistant penicillin), head and neck cancer surgery (cephalosporin), travelers' diarrhea (doxycycline), prevention of pneumonia due to Pneumocystis carinii in susceptible cancer patients (trimethoprim-sulfamethoxazole), and recurrent urinary tract infections in females (trimethoprim-sulfamethoxazole). Elective high-risk gastric and biliary tract surgery and prosthetic cardiac valve replacement may also merit prophylaxis, but the information is less conclusive.

Original languageEnglish
Pages (from-to)1-23
Number of pages23
JournalReviews of Infectious Diseases
Volume2
Issue number1
StatePublished - Jan 1980
Externally publishedYes

Fingerprint

Cephalosporins
Doxycycline
Sulfamethoxazole Drug Combination Trimethoprim
Penicillins
Penicillinase
Vaginal Hysterectomy
Pneumocystis carinii
Colorectal Surgery
Kanamycin
Neomycin
Hip Replacement Arthroplasties
Abdominal Aorta
Heart Valves
Metronidazole
Biliary Tract
Erythromycin
Head and Neck Neoplasms
Hysterectomy
Urinary Tract Infections
Cesarean Section

ASJC Scopus subject areas

  • Microbiology (medical)

Cite this

Antimicrobial prophylaxis : a critique of recent trials. / Hirschmann, J. V.; Inui, Thomas.

In: Reviews of Infectious Diseases, Vol. 2, No. 1, 01.1980, p. 1-23.

Research output: Contribution to journalArticle

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