Surgeons and infectious disease specialists: different attitudes towards antibiotic treatment and prophylaxis in common abdominal surgical infections

The role of medical infectious disease (ID) specialists in the treatment of surgical infections is increasing but no information is available regarding the therapeutic perception held by these non-surgeons treating surgical infections. The purpose of this study was to assess the attitude of the ID specialists towards antibiotic treatment and prophylaxis of common abdominal surgical infections and to compare it with that of surgeons "interested" in this field. A questionnaire, polling opinions regarding the management of common surgical infections, was sent to 396 medical ID specialists (New York State) and 515 surgeon members of the Surgical Infection Society (SIS). The questions covered areas involving choice of antibiotics, and timing and duration of treatment in given clinical scenarios, including elective and emergent colorectal surgery, perforated peptic ulcer, and appendicitis. Response rates for the medical and surgical groups were 10.1% and 15.6%, respectively. Regarding prophylactic use of antimicrobials, the pattern of administration was similar for the two groups. Regarding therapeutic use, on average medical ID specialists used antibiotics twice as long as the surgical group. The main reason identified was the failure of medical ID specialists to understand the conceptual difference between contamination and infection. Medical ID specialists may overtreat common surgical infections with antibiotics. Surgical infections should be treated by surgeons.