We read with interest the SEE question regarding a patient who claims to be allergic to penicillin (ASA Monitor, September 2019, page 64). We are concerned about the implications of the opening sentence: “Perioperative antimicrobial prophylaxis (AMP) is often the responsibility of the anesthesiologist.”

As pointed out in the discussion section for the question, anesthesiologists often lack education regarding antibiotic administration. We agree.

We write this Letter to the Editor in order to advance our opinion that the surgeon is the individual who is ultimately responsible for the choice of antibiotic (not the anesthesiologist). The surgeon determines the surgical procedure and has the training to determine the appropriate antibiotic.

The anesthesiologist does not determine the surgical procedure and may not have the training to determine the appropriate antibiotic.

We feel that the primary role of the anesthesiologist is the administration of the antibiotic.

Jesse Marymont, M.D., M.B.A., FASA...

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