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More Proof for Efficacy Than Failure

Per-Arne Kling, MD; Sven Dahlgren, MD

Arch Surg. 1989;124(6):705-707.

Abstract
• In an open, prospective, and randomized investigation on the prophylactic efficacy of peroral neomycin sulfate–erythromycin base vs intravenous ceftriaxone-metronidazole preparation in colorectal surgery, no significantly diverging results between regimens were recorded (1/27 [3.7%] and 2/27 [7.4%] wound infections, respectively). Commentary is made about the diverging results from earlier studies on antimicrobial prophylaxis and on the multifactorial causality of surgical infection. We believe that variables such as physical condition of the patients, virulence and local resistance patterns of bacteria, and technical skill of the surgeons are far more important in regard to the postoperative outcome concerning septic complications than is the choice of proper antibiotics. Thus, to determine the efficacy of antimicrobial prophylaxis, we call for larger investigations in the future, preferably double-blind, where it is possible to better control and diminish the influence of determinants other than the antibiotics being compared.

(Arch Surg 1989;124:705-707)

Author Affiliations
From the Department of Surgery, Umeå University Hospital, Umeå, Sweden.

Footnotes
Accepted for publication Oct 28, 1988.

Reprint requests to Department of Surgery, University Hospital, S-901 85 Umeå, Sweden (Dr Kling).

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