Topical Antibiotic Prophylaxis in Contaminated Wounds

Abstract

Antibiotic therapy, which has so revolutionized the treatment of established bacterial infections, has not significantly altered the incidence of postoperative wound sepsis. In theory, the surgical wound should present an ideal situation for preventative antibiotic treatment, since bacterial contamination is frequently as a small inoculum and occurs at a known time.¹ Prophylactic antibiotics given systemically have often been ineffective^2-8 and additionally carry the hazards of allergic complications and harmful alterations of the patient's indigenous flora. On the other hand, antibiotics administered locally for prophylaxis have rather consistently been effective in both experimental^9-14 and clinical studies.^15-20 If the agents are properly chosen, the use of this method can be beneficial and yet obviate the hazards of systemic antibiotic therapy. In the present study, such a regimen has been subjected to rigorous testing using an experimental wound infection in guinea pigs as a model. Methods Albino guinea pigs