What is the recommended approach to antibiotic therapy when postoperative infection is suspected?

• A. Start Broad-Spectrum Therapy for 7-14 Days Following Suspected Infection.
• B. Use Prophylactic Antibiotic Alone Without Treating Suspected Infection.
• C. Tailor Therapy to Culture Results and Discontinue When Infection Ruled Out.
• D. Stop Antibiotics Once Fever Resolves.

Answer: (C)

When postoperative infection is suspected, the aim is to treat the actual infection effectively while limiting unnecessary antibiotic exposure. The best approach is to tailor therapy to culture results and discontinue antibiotics when infection is ruled out. This means obtaining appropriate specimens for culture, starting empiric therapy if needed (especially in a severely ill patient) but then narrowing the antibiotic choice to the identified organism and its susceptibilities as soon as results are available. If cultures are negative and there is no convincing clinical evidence of an infection, antibiotics should be stopped.

This approach reduces unnecessary broad-spectrum use, lowers the risk of resistance and adverse effects, and avoids prolonged therapy that isn’t needed. In contrast, committing to a fixed broad-spectrum duration without culture guidance can lead to overtreatment; relying on fever alone to stop antibiotics is unsafe; and using antibiotics prophylactically without treating a suspected infection neglects a real infectious process.