Oxygen as an antibiotic. A comparison of the effects of inspired oxygen concentration and antibiotic administration on in vivo bacterial clearance.

Since prophylactic antibiotics and changes in tissue partial pressure of oxygen may affect bacterial clearance by different mechanisms, we tested the effects of hypoxia, hyperoxia, and normoxia with and without antibiotic administration on bacterial clearance. We found that improving tissue oxygenation by administration of normobaric oxygen decreased infectious necrosis as effectively as prophylactic antibiotic administration and that improved tissue oxygenation and antibiotic administration had an additive effect. We believe that a fraction of inspired oxygen of 45% should be added to prophylactic antibiotics as standard perioperative and postoperative care.