The current rare occurrence of post-surgical or traumatic soft-tissue anaerobic infections demonstrates the effectiveness of preventive therapy. This is based on correct surgical care of the lesions combined with preventative antibiotic therapy by penicillin G - combined with imidazoles when the presence of Bacteroides sp is suspected (e.g., in colic or rectal lesions)97. However absolute prevention is not assured. Anaerobic infections can develop under antibiotic treatment - either because they have been provided too late or because surgery has been unable to restore antibiotic penetration due to vascular injury or compression, high compartmental pressures, devascularised tissue, contamination or foreign bodies remaining. In cases of particularly soiled wounds or late referrals, preventative therapy can combine preventative HBO (5 to 7 sessions over a period of 2 to 3 days) with antibiotic therapy. However, this reasonable but as yet empirical recommendation is not supported by evidence.
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