Antibiotic Preparation Research Articles

Impact of antibiotic prophylaxis and conditioning modalities in per-oral endoscopic myotomy for esophageal motor disorders

Background and aims No recommendation regarding antibiotic prophylaxis and preparation modalities are available for patients with esophageal motor disorders who benefit from Per-Oral Endoscopic Myotomy (POEM). The aim of our study was to evaluate their impact on the POEM’s safety. Patients and methods This study was a comparative and multicentric retrospective analysis of a database prospectively collected. Patients over 18 years old with esophageal motor disorders confirmed by prior manometry, who underwent POEM were included. The primary endpoint was the occurrence of adverse events, as classified by Cotton, based on whether or not antibiotic prophylaxis was administered. Results A total of 226 patients (median age 52.9 ± 19.12 years [18–105], 116 women [51.3%]) were included. The indication for POEM was mainly type 2 achalasia (n = 135, 60.3%). Antibiotic prophylaxis was administered to 170 patients (75.2%) during 3.93 ± 3.46 days [1–21]. The overall adverse events rate was 9.3% (n = 21). Antibiotic prophylaxis was associated with the occurrence of adverse events (p = .003), but had no impact on their severity (p = .238). Antibiotic prophylaxis didn’t influence the effectiveness of POEM (1 [0–4] vs 1 [0–9], p = .231). The use of a liquid diet in the 48 h prior to the procedure was significantly associated with a lower adverse events rate (3.1% vs 6.19%, p = .0002). Conclusion The antibiotic prophylaxis during POEM does not prevent adverse events, had no impact on their severity and the efficacy of the procedure. A liquid diet before the procedure should be systematically proposed.

Assessment of the Quality of Injectable Antibiotics in Benin.

Substandard and falsified medicines are an enormous threat to global health. Poor quality antibiotic preparations contribute to the development of antimicrobial resistance. In surgery, where the occurrence of healthcare-associated infections is high, healthcare teams need to rely on the quality of antibiotic prophylaxis to prevent infections. We assessed the quality of antibiotics used for surgical infection prophylaxis in Benin. Thirty-three samples were collected from six hospitals located in various departments in Benin. The antibiotics (powders for injection: amoxicillin + clavulanic acid, ampicillin, ceftriaxone; solutions for injection: ciprofloxacin, gentamicin, metronidazole) were assessed using visual inspection, pharmacotechnical tests (including uniformity of mass, pH measure, sterility test, and active pharmaceutical ingredient identification), and assay tests (including a simple analytical method thin layer chromatography) and complex analytical techniques (ultraviolet-visible spectrophotometry, high-performance liquid chromatography-diode-array detection, conductometry). Because the material needed for the methods recommended by the pharmacopeias to assess the dosage of gentamicin was not available, we developed and validated a conductometry method. Results showed that 97% (n = 32) of the samples passed visual inspection; 100% (n = 33) of the samples passed the pharmacotechnical tests, identification of active ingredients, and sterility test; 88% (n = 29) passed the test for percentage of active pharmaceutical ingredients. Overall, 15% of the samples did not pass the quality test (3% on visual inspection and 12% for excess active ingredients). Although most of the samples passed the quality tests, it appears important to perform routine quality control for intravenous medicines.

Antimicrobial substances of natural origin: a review of properties and prospects

This article reviews data on antimicrobial additives used in the food industry for preserving the quality of food products. The use of conventional antimicrobial additives, including artificial preservatives (benzoic and sorbic acids and their salts), causes a negative response among consumers. As a result, such products are gradually disappearing from the market. At the same time, antimicrobial additives of natural origin are gaining in popularity, increasingly attracting the attention of both Russian and foreign researchers. In this article, the main antimicrobial additives of animal, vegetable and microbial origin are considered. Antimicrobial additives of animal origin are represented by lysozyme and lactoperoxidase enzymes, lactoferrin and pleurocidin peptides, as well as by chitosan, a derivative of chitin. Plant substances that exhibit antimicrobial and antioxidant properties include herbs and spices, both in native and dried form, as well as separately extracted plant components, such as essential oils, phenolic compounds and organic acids. Substances of microbial origin, in particular bacteriocins, comprise another promising class of antimicrobial additives. These forms represent smaller polypeptide molecules synthesized on ribosomes, which exhibit antagonistic activity against closely related groups of bacteria. Bacteriocins, such as nisin, natamycin, pediocin, enterocin and plantaricin, may exhibit bactericidal properties, at the same time as having little therapeutic value and no negative effect on the human intestinal microflora. This makes them different from antibiotic preparations. The conducted review confirms the prospects of using the considered additives in the composition of both food products and active packaging systems.

A quarterly Survey of antibiotic prescribing in small animal and equine practices-Minnesota and North Dakota, 2020.

Antimicrobials are critical for medicine, but the problem of antimicrobial resistance (AMR) threatens the effectiveness of these valuable drugs. In USA, there are no national- or state-level programs or policies in place to track antibiotic use (AU) in dogs, cats, and horses, despite acknowledgement of this sector's importance to both the AMR problem and its solution. AU measurement is a key part of antibiotic stewardship and AMR prevention. This study aimed to fill existing gaps in the veterinary professions' knowledge of antibiotic prescribing in small animals and horses. To address this aim, medical record data were collected on a single day per quarter for 1 year from 19 Minnesota and North Dakota small animal and equine practices, totaling 1,899 veterinarian consults of dogs, cats, and horses. Overall, 25.8% of all canine, feline, and equine consults involved an antibiotic prescription. Third-generation cephalosporins were the most commonly prescribed systemic antibiotic drug class, and the long-acting injectable drug, cefovecin, was the most commonly prescribed antibiotic for cats (34.5%). Topical antibiotic preparations were prescribed frequently, especially in dogs (42.5% of canine prescriptions), though systemic antibiotics were often prescribed concurrently. Common general indications, based on problem or diagnosis recorded in the medical record, for antibiotics in all species combined were skin conditions (24.4%), otitis (22.1%), ophthalmic (9.4%), gastrointestinal (8.3%), respiratory (8.3%), and urinary tract (7.6%) diseases. While 44.2% of patients for which antibiotics were prescribed had cytology performed, only 3.9% had bacterial culture and susceptibility performed. In a pre-study survey, veterinarians' recommendations for AU differed from actual prescribing, suggesting collection of AU data provides more accurate assessments of veterinary prescribing behaviour than surveys. This study shows feasibility of AU measurement in small animals and horses. The data collection tool and standard operating procedures described prove suitable for national AU data collection.

Are preoperative oral antibiotics effective in reducing the incidence of anastomotic leakage after colorectal cancer surgery? Study protocol for a prospective, multicentre, randomized controlled study

IntroductionThe optimal preoperative preparation for elective colorectal cancer surgery has been debated in academic circles for decades. Previously, several expert teams have conducted studies on whether preoperative mechanical bowel preparation and oral antibiotics can effectively reduce the incidence of postoperative complications, such as surgical site infections and anastomotic leakage. Most of the results of these studies have suggested that preoperative mechanical bowel preparation for elective colon surgery has no significant effect on the occurrence of surgical site infections and anastomotic leakage.Methods/designThis study will examine whether oral antibiotic bowel preparation (OABP) influences the incidence of anastomotic leakage after surgery in a prospective, multicentre, randomized controlled trial that will enrol 1500 patients who require colon surgery. The primary endpoint, incidence of anastomotic leakage, is based on 2.3% in the OABP ± mechanical bowel preparation (MBP) group in the study by Morris et al. Patients will be randomized (1:1) into two groups: the test group will be given antibiotics (both neomycin 1 g and metronidazole 0.9 g) the day before surgery, and the control group will not receive any special intestinal preparation before surgery, including oral antibiotics or mechanical intestinal preparation. All study-related clinical data, such as general patient information, past medical history, laboratory examination, imaging results, and surgery details, will be recorded before surgery and during the time of hospitalization. The occurrence of postoperative fistulas, including anastomotic leakage, will be recorded as the main severe postoperative adverse event and will represent the primary endpoint.Ethics and disseminationEthics approval was obtained from the Chinese Ethics Committee of Registering Clinical Trials (ChiECRCT20200173). The results of this study will be disseminated at several research conferences and as published articles in peer-reviewed journals. Protocol was revised on November 22, 2021, version 4.0.Trial registrationChiCTR2000035550. Registered on 13 Aug 2020.

Mechanical and oral antibiotic bowel preparation in ovarian cancer debulking: Are we lowering or just trading surgical complications?

ObjectivesTo examine postoperative complications associated with preoperative mechanical and oral antibiotic bowel preparation (MOABP) for patients with ovarian cancer who underwent bowel resection at cytoreductive surgery (CRS). MethodsThis was a single-institution retrospective study of patients with ovarian cancer undergoing CRS from 01/2011–12/2020 using ICD-10 diagnoses and procedure codes. Patients were stratified by those who underwent bowel resection versus no resection. Bowel resection patients were further stratified by those who underwent MOABP versus no bowel preparation. Patient demographics, tumor data, and perioperative metrics were collected. Unadjusted and adjusted logistic regression evaluated odds of 30-day postoperative complications in patients with bowel resection versus no resection and those with MOABP versus no bowel preparation. ResultsOf 919 patients identified, 215 (23.3%) required bowel resection, which included 81 (37.7%) who received MOABP. Patient characteristics, co-morbidities, and cancer data were similar between MOABP versus no bowel preparation patients. MOABP patients underwent more interval CRS (34.6% versus 9.0%), more optimal surgical resections (96.3% versus 83.8%), fewer diverting ostomies (13.5% versus 33.5%), and shorter hospital stays (7.1 versus 9.4 days) than no bowel preparation patients. On adjusted analyses, MOABP patients experienced significantly lower odds of deep/organ-space surgical infections and 30-day readmissions but higher odds of unplanned intensive care unit (ICU) admissions and grade 3 or higher cardiac and gastrointestinal complications. ConclusionsPatients who underwent preoperative MOABP prior to ovarian cancer CRS with bowel resection had lower odds or deep/organ-space infections and readmissions, shorter hospital stays, fewer diverting ostomies, and more optimal resections. However, these patients also experienced higher odds of ICU admissions and grade 3 or higher cardiac and gastrointestinal complications. The positive and negative postoperative outcomes in this population should be considered in clinical practice.

Synthesis, Magnetic Moment, Antibacterial, and Antifungal Studies of INH Incorporating Schiff Base Metal Complexes

The Isoniazid (INH) ring system is one of the most important heterocycles in nature, as it represents an important structural motif of many biological compounds. It possesses significant antibacterial activity and is given in combination with Rifampicin, ethambutol, or pyrazinamide. There is, therefore, an urgent need to design rapid, efficient, and environmentally benign protocols for the synthesis of metal complexation of INH-based moiety to improve its stability and bioactivity. Herein, we have developed a novel tetradentate INH incorporated Schiff base as an organic ligand, formed by the condensation reaction of INH and 4-hydroxy benzaldehyde in ethanol using glacial acetic acid resulting in the formation of N-[(E)-(4-Hydroxyphenyl)methylen]isonicotinohydrazid as primary ligand and its Cu(II), Co(II), Mn(II), Ni(II) and Zn(II) complexes having general composition [M(L)(H2O)2]·2H2O. Spectroscopic characterization such as mass, IR, UV, 1HNMR, and 13CNMR of N-[(E)-(4-Hydroxyphenyl)methylen]isonicotinohydrazid led to the conclusion that the synthesized Schiff base acts as a tetradentate organic ligand and can be used for further metal complexation. IR’s functional group frequency change confirmed its complex formation with transition metal ions. The octahedral geometry for the [M(INH-L)].2H2O is proposed based on analytical and spectroscopic data of complexes. Magnetic susceptibility study indicates newly prepared transition metal complexes are paramagnetic. Present research work has several advantages such as the eco-friendly method, easy work-up, excellent yield for the preparation of bioactive organic ligands, improved stability, and antibiotic, antifungal properties of organic ligands after complexation.

Bowel Preparation for Elective Hartmann Operation: Analysis of the National Surgical Quality Improvement Program Database.

Background: Use of pre-operative bowel preparation in colorectal resection has not been examined solely in patients who have had colorectal resection with primary colostomy (Hartmann procedure). We aimed to evaluate the association of bowel preparations with short-term outcomes after non-emergent Hartmann procedure. Patients and Methods: The National Surgical Quality Improvement Program Participant Use File colectomy database was queried for patients who had elective open or laparoscopic Hartmann operation. Patients were grouped by pre-operative bowel preparation: no bowel preparation, oral antibiotic agents, mechanical preparation, or both mechanical and oral antibiotic agent preparation (combined). Propensity analysis was performed, and outcomes were compared by type of pre-operative bowel preparation. The primary outcome was rate of any surgical site infection (SSI). Secondary outcomes included overall complication, re-operation, re-admission, Clostridioides difficile colitis, and length of stay. Results: Of the 4,331 records analyzed, 2,040 (47.1%) patients received no preparation, 251 (4.4%) received oral antibiotic preparation, 1,035 (23.9%) received mechanical bowel preparation, and 1,005 (23.2%) received combined oral antibiotic and mechanical bowel preparation. After propensity adjustment, rates of any SSI, overall complication, and length of hospital stay varied significantly between pre-operative bowel regimens (p < 0.005). The use of combined bowel preparation was associated with decreased rate of SSI, overall complication, and length of stay. No difference in rate of re-operation or post-operative Clostridioides difficile infection was observed based on bowel preparation. Conclusions: Compared with no pre-operative bowel preparation, any bowel preparation was associated with reduced rate of SSI, but not rate of re-operation or post-operative Clostridioides difficile infection.

A Rapid Assessment Model for Liver Toxicity of Macrolides and an Integrative Evaluation for Azithromycin Impurities.

Impurities in pharmaceuticals of potentially hazardous materials may cause drug safety problems. Macrolide antibiotic preparations include active pharmaceutical ingredients (APIs) and different types of impurities with similar structures, and the amount of these impurities is usually very low and difficult to be separated for toxicity evaluation. Our previous study indicated that hepatotoxicity induced by macrolides was correlated with c-fos overexpression. Here, we report an assessment of macrolide-related liver toxicity by ADMET prediction, molecular docking, structure–toxicity relationship, and experimental verification via detection of the c-fos gene expression in liver cells. The results showed that a rapid assessment model for the prediction of hepatotoxicity of macrolide antibiotics could be established by calculation of the -CDOCKER interaction energy score with the FosB/JunD bZIP domain and then confirmed by the detection of the c-fos gene expression in L02 cells. Telithromycin, a positive compound of liver toxicity, was used to verify the correctness of the model through comparative analysis of liver toxicity in zebrafish and cytotoxicity in L02 cells exposed to telithromycin and azithromycin. The prediction interval (48.1∼53.1) for quantitative hepatotoxicity in the model was calculated from the docking scores of seven macrolide antibiotics commonly used in clinics. We performed the prediction interval to virtual screening of azithromycin impurities with high hepatotoxicity and then experimentally confirmed by liver toxicity in zebrafish and c-fos gene expression. Simultaneously, we found the hepatotoxicity of azithromycin impurities may be related to the charge of nitrogen (N) atoms on the side chain group at the C5 position via structure–toxicity relationship of azithromycin impurities with different structures. This study provides a theoretical basis for improvement of the quality of macrolide antibiotics.

Synthesis of novel d-α-galactopyranosyl-l-seryl/l-threonyl-l-alanyl-l-alanine as useful precursors of new glycopeptide antibiotics with computational calculations studies

New, simple, synthetic routes for the preparation of novel glycopeptide antibiotics are described. The structures of the synthesized compounds are elucidated by IR, two-dimensional NMR spectroscopy, and mass spectrometry. The stability of the new glycopeptide derivatives 10a,b is confirmed by assessing the physical character, HOMO-LUMO gap energy, ESP, and the corresponding correlation of 2D-NMR analysis. Furtherly, the target precursors are investigated via the DFT/B3LYP/6–311(G) basis set.

78 Hand Injury and K – Wire Related Infection Rates in the Plastic Surgery Department – Closed Cycle Audit

Abstract Aim To identify the rate of K-wire infection in hand injuries and ascertain compliance with NICE guidelines on antibiotic prophylaxis and surgical skin preparation. Method Retrospective audit/service evaluation – EPR Operations first cycle (August – December 2019), and the second cycle (August – November 2020). Included all cases (adult and paediatric) of hand injuries managed with K – wire fixation – Plastic Surgery Trauma theatre lists. Results After the first cycle recommendations, the infection rates fell from 15 % to 11 %. Conclusions Infection rates were lower in the group of patients who had antibiotics on induction and on discharge.

The Prescription Pattern And Rationality Of Antibiotics Usage In General Surgery Polyclinic Patient At RSD Kalisat In October - December 2020

ABSTRACTBackground research: Antibiotics are the most widely used drug class in the world due to the high incidence of bacterial infections. The high use of antibiotics but not balanced with the rational use of antibiotics can have a negative impact, one of which is resistance. Objective: This study was conducted to examine the prescribing pattern and rationale for the use of antibiotics in the Kalisat Jember Hospital. Research method: This study used a descriptive design, data collection was carried out retrospectively which was taken from October to December 2020 at the surgical clinic at the Kalisat Jember area hospital. Result and coclusion: Based on the calculation results, the number of samples used in this study were 263 prescription sheets with antibiotics. From the results of the study, it was found that the most prescribed pattern of antibiotic prescribing was cefixime as many as 165 prescriptions (62.74%) and the most antibiotic preparations prescribed in tablet form were 253 prescriptions (96.20%). From the results of the study, it was also found that the rationality of the use of antibiotics, namely the accuracy of the dose of 100%, the accuracy of the frequency of 99.24% and the accuracy of the duration of 100%.Keywords: Antibiotic, rational, prescription

Preoperative combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery

Objectives This is a protocol for a Cochrane Review (intervention). The objectives are as follows: The aim of this review is to assess the evidence for the use of combined mechanical and oral antibiotic bowel preparation for preventing complications in elective colorectal surgery.

POTENTIAL RISKS OF THE SPREAD OF ANTIBIOTIC-RESISTANT MICROORGANISMS AND ANTIBIOTIC-RESISTANCE GENES IN POTABLE WATER - HUMAN ORGANISM CHAIN.

The aim: Determination of circulation interrelations between antibiotic-resistant microorganisms of Enterobacteriaceae family and their resistance genes in clinical strains and potable water samples taken in Uzhhorod and Uzhhorod district. Materials and methods: We carried out generic identification of the microorganisms isolated from clinical samples of the oral cavity of 64 patients suffering from periodontal inflammatory diseases, and potable water samples taken from sources of public centralized and decentralized water supply; the isolated microorganisms were tested for antibiotic sensitivity by the Kirby-Bauer disc diffusion method according to EUCAST. With the help of molecular-genetic methods, the total DNA of potable water was isolated and tested for the presence of the following genetic resistance determinants: carbapenems blaNDM; blaOXA48-like; tetracyclines blaTet-M; cephalosporins blaCTX-M. Results: In the microbiota of the clinical material and potable water samples, the same spectrum of microorganisms belonging to Enterobacteriaceae family dominated; the isolated bacteria showed a high resistance level to beta-lactam antibiotics and to natural antibiotic preparations. The highest level of resistance was established for microorganisms isolated from well water samples, where genetic resistance determinants to blaCTX-M cephalosporins and blaTet tetracyclins were also revealed. Conclusions: The obtained results proved high probability of the spread of antibiotic-resistant microorganisms and their genetic resistance determinants via potable water.

Structure‐Activity Relationship of Anionic and Cationic Polyamidoamine (PAMAM) Dendrimers against Staphylococcus aureus

Dendrimers are potent synergists, carriers, and delivery molecules for natural biological products and pharmaceuticals. Staphylococcus aureus (S. aureus) infection is causing serious diseases in humans and animals. Given the recorded antibacterial and antiviral activity of terminal‐charged PAMAM dendrimers, the relation between dendrimer charge type and generation is to be established against S. aureus. Three types of polyanionic dendrimers comprising terminal groups sodium carboxylate (generations 1.5, 2.5, 3.5, and 4.5), hydroxyl (generations 2, 3, 4, and 5), and succinamic acid (generations 2, 3, 4, and 5) and polycationic dendrimers containing primary amine (generations 2, 3, 4, and 5) were in antibacterial assays to determine their zone of inhibition and antibacterial activity. Cationic dendrimers were more potent than anionic dendrimers. The largest inhibition was shown by G(5)‐128NH2 followed by G(4)‐64NH2 primary amine dendrimers. Carboxylate, hydroxyl, and succinamic acid dendrimers showed weaker effects. Owing to their antibacterial actions, the addition of dendrimers to antibiotic preparations may increase their efficacy by their intrinsic and bacterial action by damaging the bacterial membranes as well as their usage in drug delivery.

POTENTIAL RISKS OF THE SPREAD OF ANTIBIOTIC-RESISTANT MICROORGANISMS AND ANTIBIOTIC-RESISTANCE GENES IN POTABLE WATER – HUMAN ORGANISM CHAIN

The aim: Determination of circulation interrelations between antibiotic-resistant microorganisms of Enterobacteriaceae family and their resistance genes in clinical strains and potable water samples taken in Uzhhorod and Uzhhorod district. Materials and methods: We carried out generic identification of the microorganisms isolated from clinical samples of the oral cavity of 64 patients suffering from periodontal inflammatory diseases, and potable water samples taken from sources of public centralized and decentralized water supply; the isolated microorganisms were tested for antibiotic sensitivity by the Kirby-Bauer disc diffusion method according to EUCAST. With the help of molecular-genetic methods, the total DNA of potable water was isolated and tested for the presence of the following genetic resistance determinants: carbapenems blaNDM; blaOXA48-like; tetracyclines blaTet-M; cephalosporins blaCTX-M. Results: In the microbiota of the clinical material and potable water samples, the same spectrum of microorganisms belonging to Enterobacteriaceae family dominated; the isolated bacteria showed a high resistance level to beta-lactam antibiotics and to natural antibiotic preparations. The highest level of resistance was established for microorganisms isolated from well water samples, where genetic resistance determinants to blaCTX-M cephalosporins and blaTet tetracyclins were also revealed. Conclusions: The obtained results proved high probability of the spread of antibiotic-resistant microorganisms and their genetic resistance determinants via potable water.

Analytical Strategies for the Detection and Quantification of Nano-formulated Antibiotics: Updates and Perspectives

The rapid development of drug resistant micro-organisms is a challenge to the mankind. Nano formulated compounds have proved to be effective strategy to combat bacterial drug resistance. Currently nanoparticulate systems such as nanoantibiotics are getting major attention due to their low inherent toxicity, biodegradability, bioincompatibility and tuneable mechanical characteristics. Nano formulated antibiotics are generally obtained by emulsification and gelification techniques. The effective uses of polymers in encapsulation of antibiotics show enhancement of the efficacy of antibiotics. Combined with techniques like diffraction laser spectroscopy (DLS), electron microscopy (EM) and atomic force microscopy (AFM), morphological research of nanoformulated antibiotics are conducted. The detailed study of the polymers used in the preparation of antibiotics nanoparticles as well as their impact on interactions is done by bio-analytical techniques. Antibiotics attached to nanoparticles can avoid the action of enzymes produced by drug resistant bacteria. Nano antibiotics show higher efficacy and bioavailability so a lot of new formulations using nano methods can be developed with the help of bioanalytical techniques. The development as well as the estimation of antibiotics prepared as nano-formulations as per the recent advanced techniques is illustrated in this review.

Oncologic colorectal surgical site infection: oral or not oral antibiotic preparation, that is the question.

Surgical wound infection is the most frequent postoperative complication in abdominal surgery, especially at the colorectal level. The aim of this study is analysing the results of mechanical colon preparation combined with oral antibiotic versus mechanical colon preparation without antibiotic therapy in patients with colorectal cancer undergoing elective surgery. This retrospective cohort study had been developed from November 2017 to February 2020. We have included a total of 281 consecutive patients undergoing elective colon and rectal oncological surgeries by the same surgical group using laparoscopic and open approaches. Transanal minimally invasive surgery (TAMIS) and transanal total mesorectal excision (TaTME) approaches were excluded. Exposed patients undergoing colon and rectal cancer surgery received mechanical bowel preparation and oral antibiotics with three doses of neomycin 1g and erythromycin 500mg the day before surgery. The primary outcome was reduction in surgical wound infection rates before and after starting the oral antibiotic therapy from 17 to 6% (p < 0.05). As a secondary analysis, we evaluated the anastomotic dehiscence rate, corresponding with a decrease from 12 to 3% (p < 0.05). Mechanical bowel preparation combined with oral antibiotic therapy is still not unanimously carried out in all the medical hospitals. In this report, we show that mechanical bowel preparation in combination with oral antibiotic reduces the risk of surgical wound infection and anastomotic leakage in patients undergoing colon and rectal cancer surgery.

Oral Antibiotic Prophylaxis Lowers Surgical Site Infection in Elective Colorectal Surgery: Results of a Pragmatic Cohort Study in Catalonia.

Background: The role of oral antibiotic prophylaxis (OAP) and mechanical bowel preparation (MBP) in the prevention of surgical site infection (SSI) after colorectal surgery is still controversial. The aim of this study was to analyze the effect of a bundle including both measures in a National Infection Surveillance Network in Catalonia. Methods: Pragmatic cohort study to assess the effect of OAP and MBP in reducing SSI rate in 65 hospitals, comparing baseline phase (BP: 2007–2015) with implementation phase (IP: 2016–2019). To compare the results, a logistic regression model was established. Results: Out of 34,421 colorectal operations, 5180 had SSIs (15.05%). Overall SSI rate decreased from 18.81% to 11.10% in BP and IP, respectively (OR 0.539, CI95 0.507–0.573, p < 0.0001). Information about bundle implementation was complete in 61.7% of cases. In a univariate analysis, OAP and MBP were independent factors in decreasing overall SSI, with OR 0.555, CI95 0.483–0.638, and OR 0.686, CI95 0.589–0.798, respectively; and similarly, organ/space SSI (O/S-SSI) (OR 0.592, CI95 0.494–0.710, and OR 0.771, CI95 0.630–0.944, respectively). However, only OAP retained its protective effect at both levels at multivariate analyses. Conclusions: oral antibiotic prophylaxis decreased the rates of SSI and O/S-SSI in a large series of elective colorectal surgery.

Application of solid lipid nanoparticles preparation in infection caused by antibiotic-resistant bacteria

Solid lipid nanoparticles (SLN) is a potential alternative method for drug delivery due to its good stability, low toxicity, can be modified and controlled in drug release, as well as can be produced on a large scale. The SLNs are composed of solid lipids stabilized by emulsifiers. The lipids used for SLN are physiological lipids that easily tolerated by the body. These characteristics make SLN as a potential delivery system that can increase the efficiency of an antibiotics preparation. The development of bacterial resistance to antibacterial has become serious health problems in infectious diseases. Solid lipid nanoparticles is a compelling choice as a drug delivery system that can reduce the problem of the bacterial resistance. This review discussed the role of SLN as a drug carrier system which includes the characteristics and structure of SLN, its pharmacokinetic properties, bacterial resistance mechanism, and SLN mechanism in reducing bacterial resistance.