scholarly journals Is short course of antimicrobial therapy for asymptomatic bacteriuria before urologic surgical procedures sufficient?

2011 ◽  
Vol 6 (02) ◽  
pp. 143-147 ◽  
Author(s):  
Selda Sayin Kutlu ◽  
Zafer Aybek ◽  
Koray Tekin ◽  
Demet Okke ◽  
Serife Akalin ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Antimicrobial Therapy ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Urologic Surgical Procedures ◽  
Short Course ◽  
Group A ◽  
Urological Procedures ◽  
Group B

Introduction: Duration of treatment of asymptomatic bacteriuria for patients undergoing urologic surgical procedures is undetermined. We compared the efficacy of long- versus short-course antimicrobial treatment in patients with asymptomatic bacteriuria undergoing urologic surgical procedures. Methodology: Patients were divided into two groups according to duration of antimicrobial treatment. Group A patients received a single dose of an appropriate antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the surgical procedure. If a urinary catheter was placed postoperatively, a second dose was given following the recommended dose interval. Group B patients received antimicrobial treatment prior to surgery at least until patient urine became sterile. All patients were monitored for signs and symptoms of septicemia following surgical procedures. Results: None of the patients enrolled in the study developed infectious complications such as sepsis or upper urinary tract infection. In group A, 31 patients were treated with antimicrobials before 39 urological procedures. In group B, the mean treatment time for 28 patients before 30 urological procedures was 8.03 ± 3.86 days. There were also significant differences in length of stay and the cost of antimicrobial therapy between the groups (P < 0.0001). Isolation of an increased number of resistant microorganisms was associated with long course therapy in group B. Conclusions: Short course therapy protocol may be a practical, simple approach for antibiotic use; it decreases hospital stays, eliminates delayed procedure times, lowers the economic cost of antimicrobials and lessens the chance of superinfection with and spread of antimicrobial resistant microorganisms.

scholarly journals A short course of antimicrobial therapy for asymptomatic bacteriuria is safe and effective before urologic procedures

2021 ◽  
Vol 15 (05) ◽  
pp. 742-746
Author(s):  
Murat Kutlu ◽  
Merve Arslan ◽  
Yusuf Ozlulerden ◽  
Kevser Ozdemir ◽  
Selda Sayin-Kutlu ◽  
...  
Keyword(s):  
Single Dose ◽  
Antimicrobial Therapy ◽  
Urinary Catheter ◽  
Asymptomatic Bacteriuria ◽  
Antimicrobial Treatment ◽  
Sensitivity Testing ◽  
Post Procedure ◽  
Short Course ◽  
Urological Procedures ◽  
The Mean

Introduction: In the presence of asymptomatic bacteriuria (ASB) before the urological procedure, the duration of antimicrobial treatment is controversial. This study aims to evaluate whether a short course of antimicrobial therapy is safe and effective in cases with ASB before urological procedures. Methodology: We retrospectively reviewed adult patients who had ASB before undergoing several urological procedures between 2011 and 2019. The patients received a single dose of an appropriate parenteral antibiotic, determined by antimicrobial sensitivity testing, 30 to 60 minutes before the urological procedure. If a urinary catheter was placed post-procedure, a second dose was given. Results: A total of 293 patients who had ASB before undergoing several urological procedures were included in the study. The total number of procedures was 328. Female/male ratio was 92 (31.4%)/201 (68.6%). The mean age was 63.7 ± 14.9 years. The most common isolated microorganisms were Escherichia coli (155 [47%]), Klebsiella pneumoniae (38 [11.6%]), and Pseudomonas aeruginosa (28 [8.5%]). The most common antimicrobial used was ertapenem. A second dose antimicrobial was given for 290 procedures due to a urinary catheter after a urological procedure. The mean hospitalization time was 3.97 ± 3.42 days. None of the patients developed infectious complications. Conclusions: This study has demonstrated that a single dose of parenteral antimicrobial drug administered 30-60 minutes before the urologic procedures and a second dose in the presence of a post-procedure catheter, was adequate to prevent post-procedure septicemia and urinary tract infection.

scholarly journals Incidence of post-operative cardiac complications in cardiac patients undergoing urological procedures

2015 ◽  
Vol 1 (2) ◽  
pp. 80
Author(s):  
Mastan Saheb Shaik ◽  
Venkata Rama Rao M ◽  
Sailaja K
Keyword(s):  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Cardiac Complications ◽  
Anesthetic Techniques ◽  
Ecg Changes ◽  
Arterial Blood ◽  
Group A ◽  
Urological Procedures ◽  
The Mean ◽  
Group B

Context: There are limited studies indicating the incideance of post operative morbidity and mortality in high risk patients. Urological procedures constitute a major portion of geriatric surgeries where a cardiac obligation is almost inevitable and selected for this study purpose.Aims: To compare the incidence of post operative cardiovascular complications during regional and general anesthetic techniques in patients with known cardiac risk undergoing urological surgeriesSettings and Design: Prospective randomized double blind study.Methods and Material: 40 patients aged above 50 years posted for elective urological surgeries were enrolled in the study after obtaining approval from hospital ethics committee and written informed consent from the patients. Patients were divided into two groups A& B. Group A (n=20) received general and group B (n=20) received regional anaesthesia (spinal/ Epidural). All the patients received standard premedication and their basal vitals( BP, HR, ECG pattern) were recorded. The same parameters were monitored in the post operative period at regular intervals.Statistical analysis used: Student T test is used to test the significance of stastical difference in the variables between the two groups.Results: The mean heart rate and the mean arterial blood pressure were increased (P<0.01) in the general anaesthesia group. Group A showed 10% incidence of ECG changes and group B showed 35% incidence of ECG changes. But the changes in the hemodynamics were not significant.Conclusions: There is no difference between regional anaesthesia and general anaesthesia regarding the post operative outcome after urological procedures with respective hemodynamic changes.

scholarly journals Hip hemiarthroplasty with modular neck: is it useful in residents’ learning curve? A prospective clinical trial

2020 ◽  
Vol 30 (2_suppl) ◽  
pp. 30-36
Author(s):  
Giuseppe Solarino ◽  
Lorenzo Moretti ◽  
Giovanni Vicenti ◽  
Davide Bizzoca ◽  
Andrea Piazzolla ◽  
...  
Keyword(s):  
Learning Curve ◽  
Surgical Procedures ◽  
Harris Hip Score ◽  
Modular Neck ◽  
Hip Hemiarthroplasty ◽  
Orthopaedic Surgeons ◽  
Group A ◽  
Group B ◽  
Hardinge Approach

Background: The number of femoral neck fractures (FNFs) worldwide will drastically increase in the next few decades, reaching 6.3 million by 2050. In the future, therefore, newly-qualified orthopaedic surgeons will treat this kind of injury more frequently than in past decades. This prospective observational study aims to assess whether hip hemiarthroplasty with modular neck, performed via the Hardinge approach, can be safely carried out by orthopaedic residents. Methods: Patients referred to our Level I trauma centre, between January 2016 and June 2017, with displaced intra-articular femoral fractures, were prospectively recruited. All patients underwent cemented modular bipolar hip hemiarthroplasty (Profemur Z, MicroPort Orthopedics Inc., Arlington, TN, USA) via the Hardinge approach, with the patient positioned in lateral decubitus. The surgical procedures were performed by the same surgical and anesthesiology team, under spinal anaesthesia. All patients underwent clinical and radiographic follow-up up to 24 months. Complications and re-operations were recorded. Clinical evaluation was performed using the Harris Hip Score (HHS), Osteoporosis Quality of Life Questionnaire QUALEFFO-41 and EuroQol-5D (EQ-5D) questionnaire. Anteroposterior pelvis x-rays were performed preoperatively, postoperatively and at 1, 3, 6, 12 and 24 months follow-up. Results: 118 patients met the inclusion criteria (male: 50; female: 68; mean age: 74.3 years; range 65–88 years) and were included in the current study. 67 patients out of 118 (56.8%) were managed by senior orthopaedic surgeons (Group A), whereas the remaining 51 patients out of 118 (43.2%) were treated by orthopaedic residents (Group B). Hip hemiarthroplasties performed by senior surgeons showed the prevalent use of straight (short or long) necks, whereas, in surgical procedures performed by residents, there was a significantly higher use of varus/valgus, anteverted or retroverted necks. The overall complication rate was significantly higher in Group-B patients, compared with Group-A patients ( p = 0.002). The length of hospital stay and the mean clinical scores at 24 months follow-up showed no significant differences. Conclusions: Hip hemiarthroplasty with modular neck can be safely employed during the learning curve of orthopaedic residents. Great efforts, however, should be made in future to improve residents’ training in the management of FNFs.

scholarly journals Antimicrobial Treatment Options for Granulomatous Mastitis Caused by Corynebacterium Species

2015 ◽  
Vol 53 (9) ◽  
pp. 2895-2899 ◽  
Author(s):  
Hazel C. Dobinson ◽  
Trevor P. Anderson ◽  
Stephen T. Chambers ◽  
Matthew P. Doogue ◽  
Lois Seaward ◽  
...  
Keyword(s):  
Antimicrobial Therapy ◽  
Breast Tissue ◽  
Antimicrobial Agents ◽  
Treatment Options ◽  
Antimicrobial Treatment ◽  
Granulomatous Mastitis ◽  
Sensitivity Testing ◽  
Treatment Protocols ◽  
Content Type ◽  
16S Rna

Corynebacteriumspecies are increasingly recognized as important pathogens in granulomatous mastitis. Currently, there are no published treatment protocols forCorynebacteriumbreast infections. This study describes antimicrobial treatment options in the context of other management strategies used for granulomatous mastitis.Corynebacteriumspp. isolated from breast tissue and aspirate samples stored from 2002 to 2013 were identified and determined to the species level using matrix-assisted laser desorption ionization–time of flight mass spectrometry (MALDI-TOF MS), 16S RNA sequencing, andrpoBgene targets. The MICs for 12 antimicrobials were performed using Etest for each isolate. Correlations of these with antimicrobial characteristics, choice of antimicrobial, and disease outcome were evaluated.Corynebacteriumspp. from breast tissue and aspirate samples were confirmed in 17 isolates from 16 patients. Based on EUCAST breakpoints,Corynebacterium kroppenstedtiiisolates (n= 11) were susceptible to seven antibiotic classes but resistant to β-lactam antibiotics.Corynebacterium tuberculostearicumisolates (n= 4) were multidrug resistant. Two nonlipophilic species were isolated,Corynebacterium glucuronolyticumandCorynebacterium freneyi, both of which have various susceptibilities to antimicrobial agents. Short-course antimicrobial therapy was common (median, 6 courses per subject; range, 1 to 9 courses). Patients withC. kroppenstedtiipresented with a hot painful breast mass and underwent multiple surgical procedures (median, 4 procedures; range, 2 to 6 procedures). The management ofCorynebacteriumbreast infections requires a multidisciplinary approach and includes culture and appropriate sensitivity testing to guide antimicrobial therapy. Established infections have a poor outcome, possibly because adequate concentrations of some drugs will be difficult to achieve in lipophilic granulomata. Lipophilic antimicrobial therapy may offer a therapeutic advantage. The role of immunotherapy has not been defined.

scholarly journals Prophylactic use of antibiotics as per SIGN 104 guidelines versus routine antibiotic prophylaxis for prevention of surgical site infection in clean and clean contaminated ENT surgical procedures: a comparative study

2019 ◽  
Vol 6 (1) ◽  
pp. 106
Author(s):  
M. Bharath ◽  
J. R. Galagali ◽  
Awadhesh Kumar Mishra ◽  
Ajay Mallick ◽  
E. Nikhilesh
Keyword(s):  
Surgical Site Infection ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Antibiotic Use ◽  
Site Infection ◽  
Significant Difference ◽  
Group A ◽  
Prophylactic Use ◽  
Group B ◽  
Clean Contaminated

<p class="abstract"><strong>Background:</strong> Many clinicians continue to use antibiotic prophylaxis routinely in all surgical procedures, ignoring the guidelines issued by policy makers. In this prospective study we compared the rate of surgical site infection (SSI) in patients who received prophylactic antibiotics as a routine; with the rate of SSI in patients getting antibiotics strictly as per SIGN 104 Guidelines, for clean and clean contaminated procedures.</p><p class="abstract"><strong>Methods:</strong> The study population comprised 235 patients. Group A consisted of 119 patients having 77 (65%) males and 42 (35%) females while Group B had 116 patients - 71 (61%) males and 45 (39%) females. Group A received routine antibiotic prophylaxis in all cases, while Group B received antibiotic prophylaxis as per SIGN 104 guidelines only. Both the groups were followed up for one month post-operatively for SSI and complications.</p><p class="abstract"><strong>Results:</strong> SSI occurred in 2 patients (1.68%) in Group A and in 3 (2.59%) patients in Group B. There was no significant difference in the rate of SSI between the two groups (p=0.68). Procedure wise maximum SSI occurred in tympanoplasty and laryngectomy. Due to infection one case of tympanoplasty had graft failure and one case of laryngectomy had delayed wound healing. No major complications related to infection or antibiotic use occurred in either group.</p><p class="abstract"><strong>Conclusions:</strong> Selective use of antibiotic prophylaxis as per SIGN 104 Guidelines does not lead to increase in SSI in clean and clean contaminated ENT procedures.</p>

scholarly journals Prevalence and Antibiotic Sensitivity Pattern of Asymptomatic Bacteriuria among Female Students and Staff of College of Applied Medical Sciences, Taif University.

2020 ◽  
Vol 3 (1) ◽  
pp. 862-867
Author(s):  
Taisir Saber ◽  
Nahed M. Hawsawi ◽  
Aisha hassen Alharthi ◽  
Mashael hamad Algethami ◽  
Reem Abdullah Alnefaie ◽  
...  
Keyword(s):  
Bacterial Growth ◽  
Asymptomatic Bacteriuria ◽  
Antibiotic Sensitivity ◽  
Educational Status ◽  
Medical Sciences ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Group A ◽  
Group B ◽  
Urine Specimens

Background: Asymptomatic bacteriuria (ASB) is a common condition where bacteria are present in a significant count in urine without symptoms. Pathogen persistence for a long period of time can cause urinary tract infection (UTI) that may lead to a serious complication. This study was carried out to assess the prevalence of ASB among female student and staff in College of Applied Medical Sciences, Taif university. Methods: This was a cross sectional study where a clean-catch midstream urine specimens were collected from 50 participant; 29 staff (group A) and 21 students (group B). The urine specimens were cultured quantitatively onto CLED agar plates and incubated at 35-37 ºC for 24- 48 hours. Bacterial growth equal to or more than 105 CFU/ml was considered significant. Bacteria that grew in significant count were identified by Gram stain, catalase test, coagulase test and novobiocin sensitivity.  Results: Out of the 50 urine specimens screened for ASB, two specimens (4 %) showed significant bacterial growth; where one specimen (3.4 %) in group A and one specimen (4.8 %) in group B showed significant bacterial growth. The rest of urine specimens showed either no or non-significant bacterial growth. Staphylococcus saprophyticus and Staphylococcus epidermidis were the isolated organisms. Conclusion: Low prevalence of asymptomatic bacteriuria was noted in this study. This may be due to the relatively small number of the students and staff investigated. Another likely explanation is that our target group has high educational status as socioeconomic marker.

Disaster Impact (11-M) in a Blood Bank.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 2707-2707
Author(s):  
Natalia Hernandez de Leon ◽  
Javier Anguita ◽  
Carmen Falero ◽  
Almudena Llorente ◽  
Tomas Pintado Cros ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Blood Donation ◽  
Terrorist Attack ◽  
Blood Bank ◽  
Blood Products ◽  
Patient Identification ◽  
Major Disaster ◽  
Short Period ◽  
Group A ◽  
Group B

Abstract Objective: To describe the main problems posed to a hospital’s blood bank (BB) by a major disaster situation (the11-M terrorist attack in Madrid, Spain). Report of the events: In the terrorist attack of Madrid in March 11, 2004, there were a total of 192 casualties and 1432 individuals who suffered various, usually complex, injuries. At the Gregorio Marañon Hospital 232 victims of the attack were admitted and 32 of them required surgical procedures. On this day there were 122 requests for blood products for 23 patient. Transfusion issues: Patient identification: initially most of transfusion requests arrived without patient’s demographic data nor blood sample; a numeric code was assigned to each case. Blood group testing: only ABO-type and Rh-D antigen were determined. Transfusion policy: patients were transfused with same specific ABO group whenever possible, otherwise with ABO compatible uncrossmatched red blood cells (RBC); for this purpose, retyped group A and O RBC were stored separately. Rh-D negative units were reserved for young D-negative females. Blood donation issues: There was a massive arrival of volunteers to donate blood in a very short period of time, which completely collapsed the BB facilities. It was necessary to improvise for additional space as well as technical staff and paramedical personal to attend to the massive flux of overanxious volunteers. Regular blood donors were rejected in order to guarantee blood supply after the catastrophe. Many volunteers could not donate at the time and a telephone number and address were obtained for recall at a later time if needed. Table I shows the results of HbsAg and HVC testing of blood donated on the day of the catastrophe (group B) compared with donors before the 11-M (group A). Conclusions: At a major public disaster such as the 11-M terrorist attack, donation greatly exceeds the actual needs generated by the catastrophe. Furthermore, this donation is of no use for the immediate needs. Ideally, civil authorities should not encourage blood donation indiscriminately but alert the general population to do so only after an evaluation of available resources and estimated needs. A center’s contingency plan should include: coordination with local authorities and regional blood center; hospital heads and directors should cancel all programmed activities, in particular surgical procedures and divert human effort resources to emergency care of the injured; the BB should reorganize its activities, initially focusing in patient identification and testing, redistribution and retyping of available blood products in order to deliver quickly type specific RBC; after above goals have been met, staff resources should be redistributed for blood collection and processing. Table I: Blood testing results an donation data. Total donors First-time donors Repeat donors Number HBsAg+ / VHC+ Number HBsAg+ / VHC+ Number HBsAg+ / VHC+ Between March 11 and March 14, 633 donations were made, 398 on March 11; this represent a 1,658% increment from the usual mean. There was a higher % of HCV positivity in group B compared to regular donors and no difference in HBV and HIV testing between both groups. A 662 2 / 2 323 1 / 2 339 1 / 0 B 633 1 / 5 543 1 / 5 90 0 / 0 Table II:Transfusion data. Available RCC Hospitalized Deceased Surgery Previous stock Received the 11-M Transfused 1st 4h Total transfused the 11-M During the first 4 hours 82% of the transfused patients (19) were registered at the blood bank and 63% of the RBC used that day (90 units) were transfused. 71,72% of RBC were specific ABO-group. 232 4 36 149 265 90 (62%) 143

scholarly journals Efficacy and safety of short-term chemotherapy for patients with spinal tuberculosis undergoing surgery in Chinese population: a meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lu Lin ◽  
Zhenyong Ke ◽  
Si Cheng
Keyword(s):  
Side Effects ◽  
Chinese Population ◽  
Therapy Group ◽  
Meta Analysis ◽  
Spinal Tuberculosis ◽  
Efficacy And Safety ◽  
Short Course ◽  
Short Course Chemotherapy ◽  
Group A ◽  
Group B

Abstract Objective The aim of this meta-analysis was to systematically evaluate the clinical efficacy and safety of short-course chemotherapy (≤ 6 months) compared with the standard therapy (9–18 months) for patients with spinal tuberculosis (TB) undergoing surgery in Chinese population. Methods In this meta-analysis, we searched electronic databases in the Cochrane Library, PubMed, Embase, China National Knowledge Infrastructure (CNKI), Chinese Science and Technology Periodical Database (VIP), and Wanfang data to determine the equivalence of short-course therapy (group A) and standard therapy (group B) for the drug therapy of TB in Chinese population up to December 24, 2019. Weighted mean difference (WMD), odds risk (OR), and their 95% confidence interval (CI) were calculated. All analyses of relevant outcome indicators were managed by using the Review Manager (RevMan) 5.2 software. Results This meta-analysis included six trials published involving 851 patients (group A, 397; group B, 454) with spinal TB. Results showed there were no significant differences between group A and group B in clinical cure rate (OR = 0.61; 95% CI 0.19–2.00, p > 0.05), change of erythrocyte sedimentation rate (ESR) (WMD = − 0.75; 95% CI − 3.33 to 1.83; p > 0.05) and bone graft fusion rate (OR = 2.32; 95% CI 0.36–14.81, p > 0.05). Meanwhile, there were fewer side effects (OR = 0.37; 95% CI 0.24–0.58, p < 0.05) in group A compared with group B. Conclusions The results of this meta-analysis showed that for patients with spinal TB undergoing surgery in Chinese population, short-course chemotherapy could be equivalent to the standard chemotherapy in terms of efficacy and have less side effects than the latter.

scholarly journals Empirical antimicrobial therapy of purulent-septic complications in surgical coloproctology

2019 ◽  
Vol 6 (2) ◽  
pp. 17-23
Author(s):  
Yu. M. Stoiko ◽  
V. G. Gusarov ◽  
A. L. Levchuk ◽  
A. V. Maksimenkov ◽  
D. A. Kolozyan
Keyword(s):  
Antibacterial Therapy ◽  
Antimicrobial Therapy ◽  
Antibiotic Prescribing ◽  
Defined Daily Dose ◽  
Total Consumption ◽  
Septic Complications ◽  
Empirical Antimicrobial Therapy ◽  
Daily Dose ◽  
Group A ◽  
Group B

Object. to optimize antibacterial therapy in patients with coloproctological profile with purulent-septic complications.Materials and methods. A one-center intervention study with historical control was conducted. The intervention began in January 2017, when in the hospital FSBI «N. I. Pirogov National Medical Surgical Center» Russian Ministry of Health introduced strict monitoring of compliance with the protocols of empirical antimicrobial therapy. The study included 62 patients who underwent antibacterial therapy after operations on the colon and rectum in 2016–2017. Patients were divided into two groups with respect to the beginning of the intervention: 2016 – comparison group (A), 2017 – main group (B).Results. There was a slight decrease in the total consumption of antibacterial drugs in coloproctological patients from 823.0 to 691.0 Defined Daily Dose (DDD, established daily dose), as well as the average consumption of antibiotics per patient from 26.5 to 22.3 DDD. An increase in the number of cases of compliance with the approved protocol of empirical antimicrobial therapy (AMT) was revealed from 32.3 % in group A to 67.7 % in group B, p = 0.01. The frequency of adequate empirical antibiotic prescribing increased from 71.0 to 93.5 %, p = 0.042. A significant increase in the frequency of de-escalation of AMT was revealed from 3.2 % in group A to 25.8 % in group B, p = 0.026.Conclusion. Monitoring compliance with empirical AMT protocols allowed to increase the number of cases of adherence to approved protocols, which positively affected the frequency of adequate appointment of empirical AMT, and also led to increase the number of cases of de-escalation of AMT.

Sign in / Sign up

Export Citation Format

Share Document