Antimicrobial Prophylaxis

Running Head : ANTIMICROBIAL PROPHYLAXIS

Antimicrobial Prophylaxis

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Antimicrobial Prophylaxis

The Article Antimicrobial Prophylaxis ‘ by Jason Smith and Adam Finn is an overview of what little is definitively known about the use of antibiotics in general , and specifically their preventive efficacy . The authors come to the overall conclusion that while there is general agreement that medical practice should be based on sound evidence , there are some areas where it is lacking [ , and the p]rophylactic use of antibiotics is one such area (Smith Finn , 1999 ,

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p Certainly there is much of value in the piece , if only as a reference point for patient care however , the most important details may be that further study in this area is made difficult because placebo controlled trials are often unethical ‘ and the reminder that there is little incentive for pharmaceutical companies , upon whom we seem to depend increasingly to fund clinical trials , to invest in such studies (Smith Finn , 1999 ,

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Simply put , while the risk of infection is generally low in healthy patients – regardless of procedure environment – the potential for complications , including morbidity , often prompt an attitude of better to be safe than to be sorry . In addition , because infection can occur post-operatively for a variety of unrelated reasons , even cases that might indicate a lack of efficacy for antibiotic treatment and /or prophylaxis are as easily dismissed as not

It appears that the practice of antimicrobial prophylaxis is in a state of limbo as patterns of treatment have been established ‘ but as [ .] problems [ .and] antimicrobial resistance become more prominent the balance may shift against routine use (Smith Finn , 1999 , pp . 388 389

The utilization of antimicrobials , prophylacticly or otherwise , must be examined in the same way as any other treatment : using a careful analysis of the benefits and risks on a case-by-case basis and discussed thoroughly with the patient . The complexity that this situation presents rests on two basic facts : that to conduct further study would require multicentre collaboration and large numbers of patients and , that the risk factors involved preclude a basic desire to chance any trials , let alone those of the far-reaching scope necessary to truly determine when antimicrobials are necessary versus when they are contraindicated (Smith Finn , 1999 ,

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Reference

Smith , J Finn , A (1999 . Antimicrobial prophylaxis . [Electronic version] . Arch Dis Child , 80 , 388-392

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