Single dose antibiotic prophylaxis in high risk patients undergoing transurethral prostatectomy

1987 ◽  
Vol 74 (3) ◽  
pp. 192-194 ◽  
Author(s):  
G. P. McEntee ◽  
S. McPhail ◽  
D. Mulvin ◽  
R. W. Thomson
Keyword(s):  
Single Dose ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Transurethral Prostatectomy ◽  
High Risk Patients ◽  
Risk Patients

scholarly journals Is extended preoperative antibiotic prophylaxis for high-risk patients necessary before percutaneous nephrolithotomy?

2016 ◽  
Vol 57 (6) ◽  
pp. 417 ◽  
Author(s):  
Aaron M. Potretzke ◽  
Alyssa M. Park ◽  
Tyler M. Bauman ◽  
Jeffrey A. Larson ◽  
Joel M. Vetter ◽  
...  
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Percutaneous Nephrolithotomy ◽  
High Risk Patients ◽  
Preoperative Antibiotic Prophylaxis ◽  
Risk Patients

scholarly journals Antibiotic Prophylaxis for High-Risk Patients With Acute Q Fever: No Definitive Answers Yet

2013 ◽  
Vol 58 (3) ◽  
pp. 446-447 ◽  
Author(s):  
L. M. Kampschreur ◽  
J. J. Oosterheert ◽  
P. C. Wever ◽  
C. P. Bleeker-Rovers
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Q Fever ◽  
High Risk Patients ◽  
Risk Patients ◽  
Acute Q Fever

scholarly journals Extended Antibiotic Prophylaxis May Be Linked to Lower Peri-prosthetic Joint Infection Rates in High-Risk Patients: An Evidence-Based Review

2019 ◽  
Vol 15 (3) ◽  
pp. 297-301 ◽  
Author(s):  
Christopher J. DeFrancesco ◽  
Michael C. Fu ◽  
Cynthia A. Kahlenberg ◽  
Andy O. Miller ◽  
Mathias P. Bostrom
Keyword(s):  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Evidence Based ◽  
Infection Rates ◽  
High Risk Patients ◽  
Prosthetic Joint ◽  
Risk Patients

scholarly journals A selective antibiotic prophylaxis policy for laparoscopic cholecystectomy is effective in minimising infective complications

2013 ◽  
Vol 95 (5) ◽  
pp. 345-348 ◽  
Author(s):  
F Yanni ◽  
P Mekhail ◽  
G Morris-Stiff
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Laparoscopic Cholecystectomy ◽  
High Risk ◽  
Antibiotic Prophylaxis ◽  
Gallstone Disease ◽  
Anaerobic Growth ◽  
Current Evidence ◽  
High Risk Patients ◽  
Risk Patients

Introduction It has been demonstrated previously that the identification of bactibilia during cholecystectomy is associated with the presence of one or more risk factors: acute cholecystitis, common duct stones, emergency surgery, intraoperative findings and age >70 years. Current evidence-based guidance on antibiotic prophylaxis during laparoscopic cholecystectomy (LC) is based on elective procedures and does not take into account these factors. The aim of this study was to assess the effectiveness of a selective antibiotic prophylaxis policy limited to high risk patients undergoing LC with the development of port site infections as the primary endpoint. Methods One hundred consecutive patients undergoing LC under the care of a single consultant surgeon during a one-year period were studied prospectively. Data collected included patient demographics (age, sex) as well as details of the history of gallstone disease to determine those with complex disease and risk factors for bactibilia. A single dose of antibiotics (second generation cephalosporin and metronidazole) was administered on induction to patients with a risk factor present. Information relating to all radiologically or microbiologically confirmed infections was documented. Results Eighty-four of the patients were female and the mean age was 47.7 ±16.0 years. Nineteen LCs were performed as emergencies and the remainder were elective procedures. A risk factor for bactibilia was present in 35 patients. A wound infection was identified in four cases, two of which were Staphylococcus aureus (one methicillin resistant), one was a coagulase negative Staphylococcus and one wound cultured a mixed anaerobic growth. Three of the infections occurred in patients receiving prophylaxis (2 staphylococcal and 1 anaerobic) at intervals of 7, 14 and 19 days respectively. One patient with a body mass index of 32kg/m2 in the ‘no prophylaxis’ group developed a coagulase negative staphylococcal infection at 10 days. No intra or extra-abdominal abdominal infections were identified. Conclusions This study has demonstrated that restricting antibiotic prophylaxis to high risk patients has no detrimental effects in terms of increasing the rate of infections in those with no risk factors. Furthermore, the act of not prescribing to low risk patients will limit costs and the risk of adverse events. It will also reduce the risk of resistance and clostridial infections in this cohort.

scholarly journals Results from a Phase IIa Study of the Anti-CXCL12 Spiegelmer Olaptesed Pegol (NOX-A12) in Combination with Bendamustine/Rituximab in Patients with Chronic Lymphocytic Leukemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1996-1996 ◽  
Author(s):  
Michael Steurer ◽  
Marco Montillo ◽  
Lydia Scarfò ◽  
Francesca Romana Mauro ◽  
Johannes Andel ◽  
...  
Keyword(s):  
Single Dose ◽  
High Risk ◽  
Partial Response ◽  
Peripheral Blood ◽  
Overall Response Rate ◽  
Response Rate ◽  
Tp53 Gene ◽  
Overall Response ◽  
High Risk Patients ◽  
Risk Patients

Abstract Background Olaptesed pegol (NOX-A12) is a novel, potent, L-stereoisomer RNA aptamer that binds and neutralizes CXCL12/SDF-1, a chemokine which attracts and activates immune- and non-immune cells via interaction with the receptors CXCR4 and CXCR7. Signaling of CXCL12 is pivotal to the interactions of leukemic cells with bone marrow microenvironment. The therapeutic concept of olaptesed is to inhibit such tumor-supporting pathways and thereby mobilizing and sensitizing CLL cells to therapy. Here we aim to assess the activity and safety of olaptesed in combination with bendamustine and rituximab (BR) in patients with relapsed / refractory CLL. Methods Twenty-eight relapsed or refractory CLL patients were enrolled and treated in this open-label, single-arm Phase IIa study. To investigate PK/PD, a pilot dose of 1 to 4 mg/kg olaptesed alone was administered to 3 patients per dose group (plus one additional replacement pt) before start of the regular treatment regimen (pilot group). Patients were treated using a dose titration design with intravenous (IV) olaptesed at doses increasing from 1 mg/kg to 2 mg/kg and 4 mg/kg at cycles 1, 2 and 3, respectively, at 1 hour before rituximab treatment. During cycles 4 to 6, olaptesed was dosed at the highest individually titrated dose. Rituximab was administered IV at doses of 375 mg/m² on day 1 of the 1st28-day cycle and 500 mg/m² on day 1 of subsequent cycles. Bendamustine (70 - 100 mg/m²) was given IV on days 2-3 (cycle 1) or days 1-2 (cycles 2-6) of each 28-day cycle following administration of rituximab. Clinical response was assessed according to NCI-WG Guidelines (Hallek M et al. Blood 111; 2008: 5446-56). Results To date, 24 patients completed treatment (12 women, 12 men) with a median age of 68.5 years (range 52 to 79). At screening 5, 9 and 10 patients presented with Binet stage A, B and C, respectively. The median number of prior treatment lines was 1 (range 1-2). Seven high-risk patients presented an unfavorable disease state being relapsed within 24 months after fludarabine/bendamustine treatment (5 pts) and/or presenting a deletion/mutation of the TP53 gene (3 pts). Most patients (19 of 24) were previously treated with fludarabine or bendamustine. A flow cytometric analysis of CD19+/CD5+CLL cells showed a rapid mobilization into the peripheral blood by a single dose of olaptesed which lasted throughout the observational time of 72h. Interestingly, CXCR4 expression levels increased on CLL cell surface in the periphery after olaptesed treatment. This increase, which peaked at 24h, likely reflects the extended circulation of CLL cells in the periphery due to the sustained blockade of CXCL12 by olaptesed. Reduction of lymphadenopathy by ≥ 50% was achieved in 14 out of 21 evaluable patients with reported enlarged lymph nodes by the end of treatment. Concomitantly, rapid reduction of lymphocytosis in peripheral blood with normalization by treatment cycle 2 – 3 was observed and the CLL to leukocyte ratio significantly improved. Efficacy was assessed at the end of cycles 3 and 6. In the full-analysis-set, which excludes two non-evaluable patients (drop-out after the 1st cycle due to adverse events), the overall response rate was 96%: Three patients (14%) achieved a complete response at end of cycle 6 (2 confirmed, 1 investigator reported) and eighteen patients (82%) achieved a partial response (fifteen at end of cycle 6 and three at end of cycle 3). Notably, all seven high-risk patients (defined as relapsed within 24 months after fludarabine/bendamustine treatment and/or presenting a deletion/mutation of the TP53 gene) responded to treatment with olaptesed + BR with a partial response. One patient had a progressive disease. Olaptesed at 1, 2 and 4 mg/kg at a single dose and in combination with BR was safe and well tolerated. The observed adverse reactions were qualitatively and quantitatively as expected for patients treated with BR. Conclusion Olaptesed in combination with BR was safe and well tolerated. Compared with historical data, olaptesed showed superiority over baseline therapy with regards to overall response rate and increasing rates of complete remission, warranting further development of this Spiegelmer in CLL. Disclosures Montillo: Janssen: Honoraria. Kruschinski:NOXXON Pharma AG: Employment. Dümmler:NOXXON Pharma AG: Employment. Riecke:NOXXON Pharma AG: Employment.

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