Influence Of Antibiotic Prophylaxis Research Articles

Influence of antibiotic prophylaxis on wound infection incidence after elective laparoscopic cholecystectomy.

There have been controversies about whether prophylactic antibiotics are necessary in elective laparoscopic cholecystectomy. The aim of this study is to analyse the effect of different risk factors and antibiotic prophylaxis on the rate of wound infection following elective laparoscopic cholecystectomy. This is a retrospective study of patients with elective laparoscopic cholecystectomy from January 2021 to December 2022. The evaluated factors were: gender, age, diabetes, smoking, body mass index, haemoglobin level, American Society of Anesthesiologists physical status classification, surgery duration, intraoperative bile spillage and use of antibiotic prophylaxis. This study included 243 patients. The incidence of wound infection was significantly higher in male patients (p = 0.021). There was no statistically significant correlation between other risk factors and postoperative wound infection. Elective laparoscopic cholecystectomy patients do not benefit from antibiotic prophylaxis, which should be limited to complicated and acute cases.

The influence of antibiotic prophylaxis on bacterial resistance in urinary tract infections in children with spina bifida

BackgroundBacterial resistance to antibiotics is an increasingly threatening consequence of antimicrobial exposure for many decades now. In urinary tract infections (UTIs), antibiotic prophylaxis (AP) increases bacterial resistance. We studied the resistance patterns of positive urinary cultures in spina bifida children on clean intermittent catheterization, both continuing and stopping AP.MethodsIn a cohort of 176 spina bifida patients, 88 continued and 88 stopped using AP. During 18 months, a fortnightly catheterized urine sample for bacterial pathogens was cultured. UTIs and significant bacteriuria (SBU) were defined as a positive culture with a single species of bacteria, respectively with and without clinical symptoms and leukocyturia. We compared the percentage of resistance to commonly used antibiotics in the isolated bacteria in both groups.ResultsIn a total of 4917 cultures, 713 (14.5%) had a positive monoculture, 54.3% of which were Escherichia coli. In the group stopping AP, the resistance percentage to antibiotics in UTI / SBU bacteria was lower than in the group remaining on AP, even when excluding the administered prophylaxis.ConclusionStopping antibiotic prophylaxis for urinary tract infections is associated with reduced bacterial resistance to antibiotics in children with spina bifida.Trial registrationISRCTN ISRCTN56278131. Registered 20 December 2005.

Quality of Life in Children with Spina Bifida: A Cross-Sectional Evaluation of 102 Patients and their Parents

Background: In the so-called SPIN UTI study on 176 patients with spina bifida and clean intermittent cathererization (CIC) we have studied the influence of antibiotic prophylaxis (AP) on the number of yearly urinary tract infections (UTIs) and bacterial resistance to commonly used antibiotics. We have proven that stopping AP increased the number of yearly UTIs only slightly and clinically irrelevant patients would have to take AP for two years to prevent one extra non-febrile, non-scarring UTI, We have also shown that bacterial resistance improved over time when AP was stopped. In this article we study the influence of the recommended discontinuation of AP on Health Related Quality of Life (HRQL) in spina bifida. Methods: Participating children aged 4-16 years and their parents were asked to fill out the validated KINDL-R questionnaire, combined with specific spina bifida questions. Scores in study participants were compared with healthy controls. Also, the impact of AP, gender, level of spinal lesion, hydrocephalus, methods of catheterization and defecation, mobility and level of schooling on HRQL was evaluated. Results: One hundred and two of the 133 eligible children (77%) filled out the KINDL-R. Patients and their parents had significantly lower HRQL scores than healthy controls (p<0.001). Parents had significantly lower scores than their children, especially in the psychological domains. Severity of co-morbidity was not associated with differences in HRQL. There were no differences between children who continued and stopped AP. Conclusions: HRQL scores are lower in spina bifida patients compared to healthy children. Parents have even lower scores, especially in the psychological domains. Stopping antibiotic prophylaxis does not adversely affect HRQL, and should therefore be pursued to improve bacterial resistance patterns in spina bifida patients.

Influence of antibiotic prophylaxis on perioperative risk in traumatology with the new concept of clinic modelling randomized trials in animals

Abstract Background Surgical outcome depends not only on different therapies, but also on different additionally applied measures like prophylaxis (antibiotics, heparin, etc.) and their complex interaction. The aim of this study was to establish a new concept of clinic modelling randomized trials (CMRTs) in rats (haemorrhagic shock model) to investigate the harmful or beneficial effects of antibiotic prophylaxis in trauma patients (evidence-based medicine). Elements of the clinical scenario and methodology of randomized trials were modelled as accurately as possible in this CMRT. Methods Conditions of the rat model (CMRT) were adapted to the methodology of clinical trials and the clinical scenario with respect to sample size calculation, blinding and randomized allocation in a two-block design (n = 20 animals per group), anaesthesia with fentanyl–droperidol, standardized operation (soft tissue damage, tibia fracture and nailing), antibiotic prophylaxis 1 h before operation (intravenous cefuroxime 20 mg kg−1 versus placebo (sodium chloride)), volume substitution (Ringer) and postoperative analgesia. The clinical situation of healthy (American Society of Anesthesiologists (ASA) grade I and II) and severely injured (ASA III and IV) patients was simulated in the CMRT by sham operation and preoperative blood-letting, respectively, to initiate a relevant shock (1·5 h of mean arterial pressure 50 mmHg, blood pressure measured in the femoral artery). The shock period was followed by resuscitation (volume loading) with Ringer solution 40 ml kg−1. The endpoint was the 21-day mortality rate. Fracture healing was documented by radiography. Results The animal model was established successfully. The required blood-letting for relevant shock was 20 ml kg−1. The mortality rate in animals without blood-letting simulating healthy patients (ASA I and II) was zero in the cefuroxime and in placebo groups (n = 20 per group). In the experiment with preoperative blood-letting (ASA III and IV, n = 20 per group) a clear but not significant trend in the mortality rate for the cefuroxime group (20 per cent) versus placebo (40 per cent) could be observed (1 d.f., P &amp;gt; 0·05, χ2 test). Disturbances of fracture healing did not occur. Conclusion The clinical impact (evidence based) of antibiotic prophylaxis in traumatology was demonstrated in these experiments. The influence of other currently used antibiotics in trauma patients could be investigated in such animal models (CMRTs) instead of expensive and time-consuming clinical trials. The results of this study suggest the advantage of prophylaxis with cefuroxime in severely injured patients. Other antibiotics and the pathophysiological mechanisms will be investigated in further studies.

Influence of antibiotic prophylaxis on mortality and perioperative histamine release in trauma: experiments with clinic modelling randomized trials in animals.

Influence of antibiotic prophylaxis on mortality and perioperative histamine release in trauma: experiments with clinic modelling randomized trials in animals.