Failure of cephalosporins to prevent Staphylococcus aureus surgical wound infections

Article Abstract:

There are approximately 35,000 Staphylococcus aureus infections of surgical wounds per year in the United States despite the use of cephalosporin antibiotics such as cefamandole and cefazolin during surgery. The clinical isolates, or microorganisms obtained from deep wound infections, in 18 of 1,650 patients given cefazolin and 17 of 3,702 patients given cefamandole were compared with isolates from presurgical patients. The S. aureus bacteria isolated from cefazolin-treated patients were more resistant or insensitive to cefazolin than those obtained from cefamandole-treated and presurgical patients. Specific variants, or forms of the beta lactamase enzyme, produced by Staphylococcus aureus were associated with infections in cefamandole- and cefazolin-treated patients. These beta lactamase enzyme variants may be involved in degrading the cephalosporin antibiotics, thereby preventing the antibacterial actions of these drugs during surgery. The results indicate that surgical wounds infected by the bacteria S. aureus result from the ineffectiveness of antimicrobial drug treatment with cephalosporins. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Surgical wound infections, Staphylococcal infections, Cephalosporins

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Computerized surveillance of adverse drug events in hospital patients

Article Abstract:

A computerized hospital information system may be able to detect adverse drug reactions in patients that their doctors might miss. Medical records of 36,653 hospital patients were monitored by a computer for signs of an adverse drug reaction over an 18-month period. Doctors, nurses and pharmacists were also allowed to enter an adverse drug reaction into the computer. By the end of the study, the computer contained 731 reports of adverse drug reactions in 648 patients. Only 90 of the reports were entered by health care personnel; the other 641 were detected by the computer. Only nine adverse drug reactions were reported using traditional detection methods during the study. Of the adverse drug reactions collected by the computer, 701 were serious enough to require a change in treatment. More than half of the adverse drug reactions occurred in patients over the age of 60. Analgesics (pain-killers), antibiotics and cardiovascular drugs caused the largest number of adverse drug reactions.

Drugs, Information management, Medical records, Drug use, Adverse drug reactions

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Adverse drug events in hospitalized patients: excess length of stay, extra costs, and attributable mortality

Article Abstract:

Adverse drug reactions in hospitalized patients appear to cause deaths, prolong hospital stays, and increase costs. Researchers compared outcomes between 1,580 hospitalized patients experiencing an adverse drug reaction with 20,197 similar patients. Patients having adverse reactions were nearly twice as likely to die, averaged two days longer in the hospital, and increased hospital costs by an average of $2,000. Half of all adverse drug reactions could be prevented by calculating drug dosage based on weight and kidney function, taking account of known allergies, and eliminating mistakes in giving medications.

Patient outcomes, Mortality, Hospital utilization, Hospital stays, Medication errors, Drug allergy, Drug hypersensitivity

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