Antibiotic prophylaxis with cefotaxime in gastroduodenal and biliary surgery
Article Abstract:
Surgical wound infections have been reported to occur in about 3 percent of clean wounds, 5 percent of emergency operations, and 7.8 percent of operations when there were factors that predisposed the patient to infection. Prophylactic antibiotics, particularly cefoxitin, are used in gastroduodenal (stomach and intestinal) and biliary (gallbladder related) surgery when there is a risk of infection. It has been suggested that a single dose of cefotaxime given before surgery significantly reduces the incidence of wound infection in gastroduodenal and biliary surgery. A prospective, randomized, multicenter study was undertaken to evaluate the effectiveness in cefotaxime in reducing the incidence of wound infection. There were 1,451 patients with infection risk factors, who underwent gastroduodenal or biliary surgery; 722 were given cefotaxime and 729 were given cefoxitin. The incidence of wound infection in the cefotaxime group was 3.3 percent compared with 7.6 percent in the cefoxitin group. Time of administration of cefotaxime before surgery influenced the frequency of wound infections; patients given cefotaxime one hour or less before surgery had the lowest rate of wound infection (0.63 percent). The duration of surgery influenced the wound infection rate in both the cefoxitin and the cefotaxime groups. Patients who developed wound infection remained in the hospital an average of three days longer than patients without wound infection. A cost analysis indicated that use of cefotaxime preoperatively may reduce costs. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Subject: Health
ISSN: 0002-9610
Year: 1989
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Oral antimicrobial therapy for osteomyelitis
Article Abstract:
Osteomyelitis is an infection of the bone, the treatment of which generally consists of surgical cleaning of the infected bony and soft tissue structures and antibiotics. These antibiotics have until very recently been given intravenously. Recent advances in oral antibiotic therapy have yielded newer agents are able to penetrate into bone and, in many cases are curative. This has markedly decreased the amount of hospitalization time for the osteomyelitis patient. One new oral antibiotic agent that has been used for osteomyelitis is ciprofloxacin. In one study, ciprofloxacin was well-tolerated by 98 percent of the patients and provided cure for approximately 76 percent. By comparison, the intravenous antibiotic ceftazidime had cure rate between 86 and 92 percent, depending on the organism involved. While the oral agents may not have the same degree of success as the intravenous antibiotics, certain elderly, debilitated, or institutionalized patients might be ideal candidates for oral treatment. With either antibiotic regimen, however, complete surgical debridement of the area is necessary to eradicate the infection. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1991
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