title: Controversies in antimicrobial prophylaxis.
abstract: This paper examines four controversies in antimicrobial prophylaxis. Duration of prophylaxis: Antimicrobial agents must be present in the tissues throughout the operation. Usually, a single preoperative or intraoperative dose will suffice; postoperative doses are unnecessary. Third-generation cephalosporins: no clinical evidence supports their use for surgical prophylaxis. Optimal prophylaxis for colorectal surgery: the information is conflicting, but oral agents combined with a parenteral antibiotic may be optimal. Prophylaxis for patients with indwelling prosthetic joints or vascular grafts: prophylaxis is unnecessary for procedures like dental work that cause transient bacteremia, but established infections should receive prompt, vigorous antimicrobial therapy.
authors.forename: J V
authors.initials: JV
authors.lastname: Hirschmann
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001807:Blood Vessel Prosthesis; D002511:Cephalosporins / Q000627:therapeutic use; D003106:Colon / Q000601:surgery; D004334:Drug Administration Schedule; D006801:Humans; D007595:Joint Prosthesis; D011292:Premedication; D012007:Rectum / Q000601:surgery; D018805:Sepsis / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins