“prophylactic” use of antibiotics

A particular source of concern is the “prophylactic” use of antibiotics—to compensate for unhygienic conditions or just on general principles:
Antibiotic prophylaxis against the bacterial world at large is not practical and, in fact, may induce more infection than it aims to prevent ... [It] does little more than ensure that the superimposed infections will be resistant to the antibiotics used. One survey showed that two-thirds of all patients who were admitted, exclusive of the obstetric and newborn services, received antibiotics, most of which were given prophy-lactically before operations. In another study, bacterial complications in clean operations were five times higher in prophylactically treated patients than in patients not given antibiotics prophylactically ... Prophylaxis is often used but is not only valueless, but also sometimes dangerous in viral infections, routine preoperative or postoperative care, comatose patients, bulbar poliomyelitis, tracheotomized patients, very ill patients with noninfectious diseases, and patients receiving steroid therapy.—B. M. Kagan et al., 1973