Dr Hunt: The role of antibiotics for treatment of established bacterial infection is well known and, in general, we agree on methods. On the other hand, most antibiotics prescribed by surgeons are given for indications that are controversial. It appears to me that recent research is bringing some logic where the controversy was previously at a stalemate. We may be reaching a consensus on the indications for antibiotics used to prevent operative infections, but how does one best manage antibiotics in the perioperative period?
The cardiac surgery group at the University of California set out to determine whether "prophylactic" antibiotics actually prevent infection in patients undergoing open heart surgery. Some onlookers believed that it was immoral to withhold antibiotics from the control group. Others believed that the test was long overdue because antibiotics given prophylactically had merely led to "superinfection." In the end, the control group given no antibiotics fared