Reply to Peiffer-Smadja, et al.

We have read with interest the letter by Peiffer-Smadja and colleagues titled ‘Cultural differences between surgical and medical teams: is it time for comanagament’. The authors discuss the findings from an ethnographic study we conducted which described the differences in culture and team dynamics across medical and surgical specialties in relation to antibiotic decision-making and suggest a way forward to be co-management of the surgical patient. The European Journal of Internal Medicine have also just issued a strategy for co-management to improve outcomes of perioperative care. There are existing longstanding examples of effective multidisciplinary co-management from other disciplines, for example in HIV and TB that include nurse and pharmacist and are not limited to doctors.