Development of a new pharmacokinetic model for target‐concentration controlled infusion of cefoxitin as a prophylactic antibiotic in colorectal surgical patients

2021 ◽  
Author(s):  
Kyung Mi Kim ◽  
Sung‐Hoon Kim ◽  
Ho‐Yong Yun ◽  
Jiwon Jung ◽  
Ji‐Yeon Bang ◽  
...  
Keyword(s):  
Pharmacokinetic Model ◽  
Prophylactic Antibiotic ◽  
Surgical Patients ◽  
Target Concentration

Prophylactic Antibiotic Management of Surgical Patients Noted as “Allergic” to Penicillin at Two Academic Hospitals

2016 ◽  
Vol 6 (9) ◽  
pp. 263-267 ◽  
Author(s):  
Richard H. Epstein ◽  
Paul St. Jacques ◽  
Jonathan P. Wanderer ◽  
Mark R. Bombulie ◽  
Niraj Agarwalla
Keyword(s):  
Prophylactic Antibiotic ◽  
Surgical Patients ◽  
Academic Hospitals ◽  
Antibiotic Management

scholarly journals Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital.

2016 ◽  
Vol 43 (4) ◽  
pp. 225-234 ◽  
Author(s):  
MARISE GOUVÊA ◽  
CRISTIANE DE OLIVEIRA NOVAES ◽  
ANTONIO CARLOS IGLESIAS
Keyword(s):  
Antibiotic Prophylaxis ◽  
Prophylactic Antibiotic ◽  
University Hospital ◽  
Surgical Patients ◽  
Antibiotic Administration ◽  
Surgical Antibiotic Prophylaxis ◽  
The Right

ABSTRACT Objective : to evaluate the antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital - HUGG. Methods : we conducted a rospective study of a cohort of 256 patients undergoing elective operations between January and September 2014. We collected data on demographics, use or not of prophylactic antibiotic and the antibiotic prophylaxis following characteristics: type of antibiotic used, moment of administration and duration of postoperative use. The analyzed outcomes were "justified use or non-use of antibiotic prophylaxis", "correct antibiotic choice," "administration of the antibiotic at the right time" and "discontinuation of the antibiotic at the right time." Results : antibiotic prophylaxis was used in 91.8% of cases. The use or non-use of antibiotic prophylaxis was justified in 78.9% of patients, the choice of the administered antibiotic was considered correct in 97.9%, antibiotic administration was made at the right time in only 27.2% of patients and discontinuation of the antibiotic was performed at the correct time in 95.7% of cases. Conclusion : the surgical antibiotic prophylaxis was not fully adequately performed in the sample.

scholarly journals Remifentanil Concentration during Target-controlled Infusion of Propofol

2002 ◽  
Vol 30 (5) ◽  
pp. 578-583 ◽  
Author(s):  
D. P. Crankshaw ◽  
C. Chan ◽  
K. Leslie ◽  
A. R. Bjorksten
Keyword(s):  
High Performance ◽  
Sequential Analysis ◽  
Surgical Patients ◽  
Target Concentration ◽  
Blood Concentrations ◽  
Remifentanil Infusion ◽  
Arterial Blood ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Written Informed Consent

After institutional approval and with written informed consent, eight surgical patients were infused intravenously with remifentanil at 250 ng.kg lean body mass (LBM) -1 .min -1 for 30 min. Cardiovascular and respiratory parameters were recorded and arterial blood samples were taken at regular intervals. In each patient, the same protocol was repeated 40 min later during propofol infused to a target concentration of 3.0 μg.ml -1. Blood concentrations of remifentanil and propofol were assayed using capillary gas chromatography and high performance liquid chromatography techniques respectively. The number of subjects enrolled was determined by testing the successive areas under the remifentanil time-concentration curve (AUC) for significant difference or non-difference using sequential analysis. The median measured propofol concentration was 3.5 (range: 2.6–4.5) μg.ml -1 which did not change significantly during the second remifentanil infusion. The median AUC during propofol infusion was greater than control in all subjects, although there was considerable variation of 94.4 (64.3–129.6) versus 64.6 (34.8–126.9) ng.ml -1 .min; P=0.008, n=8. After 30 min, there was no significant difference in remifentanil concentration during propofol infusion when compared with remifentanil alone of 4.6 (3.2–5.7) versus 3.8 (1.6–4.9) ng.ml -1; P=0.73, n=8. Co-administration of propofol and remifentanil may result in greater remifentanil concentrations than when remifentanil is infused alone.

ALFENTANIL PHARMACOKINETIC MODEL APPLIED TO AMBULATORY SURGICAL PATIENTS

1988 ◽  
Vol 69 (3A) ◽  
pp. A243-A243 ◽  
Author(s):  
D B RAEMER ◽  
A BUSCHMAN ◽  
M D JOHNSON ◽  
B K PHILIP ◽  
S L SHAFFER
Keyword(s):  
Pharmacokinetic Model ◽  
Surgical Patients

Prophylactic Antibiotics in Pediatric Surgery

PEDIATRICS ◽  
1982 ◽  
Vol 69 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Richard W. Kesler ◽  
Linda J. Guhlow ◽  
Frank T. Saulsbury
Keyword(s):  
Pediatric Surgery ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Surgical Patients ◽  
Postoperative Prophylaxis ◽  
Preoperative Prophylaxis

The frequency and appropriateness of prophylactic antibiotic use in children less than 6 years of age who received surgery were examined. Antibiotics were prescribed for 62% of children who had surgery, and prophylaxis was the sole reason for antibiotic use in 73% of the patients. Prophylactic antibiotics were administered inappropriately with respect to timing or duration to 42% of the children receiving preoperative prophylaxis, 67% receiving intraoperative prophylaxis, and 55% receiving postoperative prophylaxis. Thus, prophylaxis alone is the major indication for antibiotic use in pediatric surgical patients, and prophylactic antibiotics are frequently administered inappropriately.

Prevalence of Nosocomial Infections After Surgery in Greek Hospitals: Results of Two Nationwide Surveys

2004 ◽  
Vol 25 (4) ◽  
pp. 319-324 ◽  
Author(s):  
Achilleas Gikas ◽  
Maria Roumbelaki ◽  
John Pediaditis ◽  
Pavlos Nikolaidis ◽  
Stamatina Levidiotou ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infections ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Antibiotic Use ◽  
Developed Countries ◽  
Surgical Patients ◽  
Prevalence Studies ◽  
Day Range ◽  
Greek Hospitals

AbstractObjective:To determine the frequency and type of nosocomial infections (NIs) (especially surgical-site infections [SSIs]), risk factors, and the type and duration of antibiotic use among surgical patients in Greek hospitals.Design:Two point-prevalence studies.Setting:Fourteen Greek hospitals.Patients:Those in the hospitals during two prevalence surveys undergoing surgery during their stay.Results:In the 1999 survey, 129 of 1,037 surgical patients had developed 148 NIs (14.3%). A total of 1,093 operations were registered, and 49 SSIs (4.5%) were found. In the 2000 survey, 82 of 868 surgical patients had developed 88 NIs (10.1%). A total of 902 operations were registered, and 38 SSIs were detected (4.2%). The median length of stay (LOS) for surgical patients without SSI was 10.0 days (range, 1-19 days); for patients who developed SSI it was 30 days (range, 1-52 days; P < .001). The median LOS prior to surgery for patients without SSI was 1 day (range, 0-4 days); for patients who developed SSI it was 3 days (range, 0-7.5 days; P < .001). Among 30 possible risk factors studied, wound class, LOS prior to surgery, and central venous catheterization were independent predictors of SSI. Median durations of prophylactic antibiotic therapy were 4 days (range, 1-14 days) and 6 days (range, 1-16 days) in the 1999 and 2000 surveys, respectively.Conclusion:Surgical patients in Greek hospitals suffered higher rates of SSI than did surgical patients in other developed countries while prophylactic antibiotics were used excessively.

Predictive Accuracy of Target-controlled Propofol and Sufentanil Coinfusion in Long-lasting Surgery

2000 ◽  
Vol 93 (3) ◽  
pp. 653-661 ◽  
Author(s):  
Pierre C. Pandin ◽  
Francis Cantraine ◽  
Patricia Ewalenko ◽  
Stéphane C. Deneu ◽  
Eddy Coussaert ◽  
...  
Keyword(s):  
Prospective Study ◽  
Pharmacokinetic Model ◽  
Predictive Accuracy ◽  
Hemodynamic Changes ◽  
Target Concentration ◽  
Target Controlled Infusion ◽  
Performance Error ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Infusion Period

Background The predictive accuracy of target concentration infusions of propofol has been documented only for less than 4 h, and no prospective study of sufentanil target controlled infusion is available. The authors investigated the predictive accuracy of pharmacokinetic models for propofol and sufentanil coadministered during long-lasting surgery. Methods Ten patients, American Society of Anesthesiologists physical status I and II, were studied during extended cervicofacial surgery. Target controlled infusion of propofol and sufentanil was administered during surgery using decisional algorithms, taking into consideration pain assessment, hemodynamic changes, and peroperative blood losses. Intrasubject data analysis included calculation of performance error, median performance error, median absolute performance error, divergence, and wobble. Results The range of plasma target concentrations was 2-5 microgram/ml for propofol and 0.2-1 ng/ml for sufentanil. Median performance error was -12.1% for propofol and -10% for sufentanil. The wobble values were 11.6% and 22.3% for propofol and sufentanil, respectively. The pharmacokinetic sets used slightly overpredicted the concentrations, with negative values of divergence of 2.92% and 0.22% units/h for propofol and sufentanil, for a mean infusion period of 762 min. Conclusions This prospective study demonstrates the predictive accuracy of the pharmacokinetic model for sufentanil infusion and confirms that for propofol during long-lasting surgery using standardized rules for the management of target controlled infusion and blood loss replacement.

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