Antibiotic Prophylaxis in Surgical Procedures

Guglielmo, B. Joseph

doi:10.1001/archsurg.1983.01390080045013

Cited by 148 publications

(11 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Because of the bacterial load in the largebowel lumen, septic complication after colo rectal surgery is common without prophylactic antibiotics [1,2], Other factors including oper ative technique, prolonged operation [13], contamination of peritoneal cavity at oper ation, use of mechanical bowel preparation [3], emergency surgery [14], different types of colorectal resection and anastomosis [15], and even blood transfusion [14] have been impli cated to affect the post-operative septic com plication rate. In this study we have standard ised the mechanical bowel preparation, elim inated the emergency cases and included only those colorectal resectional cases, and the pa tients were stratified into three categories ac-cording to the types of resection.…”

Section: Discussionmentioning

confidence: 99%

“…The post-operative infection rate is 40-60% in elective colorectal surgery without prophylactic antibiotics [1,2], Mechanical cleaning of the bowel by reducing the amount of faecal matter in the colon at the time of op eration has little effect on the colonic bacterial count (31. The concept of reducing the bacte rial load in the colon at the time of surgery by pre-operative oral antibiotics decreases the post-operative infection rate in colorectal sur gery [4], but studies have shown that oral anti biotics can lead to the development of resis tant organisms [5, 61. Prophylactic parenteral antibiotics arc most widely used in elective colorectal oper ations [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Amoxycillin and Clavulanic Acid versus Cefotaxime and Metronidazole as Antibiotic Prophylaxis in Elective Colorectal Resectional Surgery

Kwok

Lau²,

Leung³

et al. 1993

Chemotherapy

View full text Add to dashboard Cite

In a prospective randomised controlled trial, amoxycillin plus clavulanic acid was compared to a combination of cefotaxime and metronidazole as prophylactic antibiotics in 164 patients who underwent elective colorectal resectional surgery. Wound infection occurred in 15 patients (9.1%) and deep surgical infection in 4 (2.4%). Seven cases of wound infection and 2 cases of deep infection occurred in the amoxycillin plus clavulanic acid arm, while 8 cases of wound infection and 2 cases of deep infection occurred in the cefotaxime plus metronidazole arm. Eighty-eight percent of infections occurred in patients who had low anterior resection or abdominoperineal resection of the rectum. Both the amoxycillin plus clavulanic acid and the combination of cefotaxime and metronidazole offer the same degree of protection against post-operative infection. The use of amoxycillin plus clavulanic acid as antibiotic prophylaxis is recommended because of its easier use and cheaper cost.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Amoxycillin and Clavulanic Acid versus Cefotaxime and Metronidazole as Antibiotic Prophylaxis in Elective Colorectal Resectional Surgery

Kwok

Lau²,

Leung³

et al. 1993

Chemotherapy

View full text Add to dashboard Cite

show abstract

“…For effective antimicrobial prophylaxis, adequate concentra tions of the drug must be present in the tissues at the onset and throughout the operative procedure. As a broadly accepted guideline, the antibiotics should be given within 30 min before the beginning of the surgical procedure, that means with induction of anesthesia and a single preopera tive dose provides optimal prophylaxis [4,5,[10][11][12][13][14][15][16][17], Post operative administration of prophylactic drugs is unneces sary and may be harmful. In operations of a long duration, an antibiotic with a short half-life (1-2 h) must be re peated.…”

Section: Basicsmentioning

confidence: 99%

“…The colon contains between 10" and 1012 organisms/ ml of feces and the ratio of anaerobes to aerobes is between 100 and 1,000 to 1 [11,20]. The most common pathogens are Escherichia coli and Bacteroides fragilis.…”

Section: Colon and Rectummentioning

confidence: 99%

Standards of Antibiotic Prophylaxis in Abdominal Surgery

A¹,

Büchler²

1996

Dig Surg

View full text Add to dashboard Cite

The prophylactic use of antimicrobial agents is recommended for the prevention of numerous postoperative infections. Except for oral bowel preparations, antimicrobial prophylaxis should be limited to the operative period. Prolonged perioperative prophylaxis has not been shown to enhance effectiveness. The possibilities for toxicity, resistant superinfections and rising costs are discussed. This article provides an overview together with the standards of antimicrobial prophylaxis in abdominal surgery, principles of antibiotic administration and the choice of appropriate agents.

show abstract

“…Short-course therapy with an antimicrobial active agent against Staphylococcus aureus and Staphylococcus epidermidis has been recommended in open-heart surgery, particularly in procedures including placement of a prosthetic valve (5,9,10). Clindamycin, methicillin, vancomycin, and various cephalosporins have been considered as useful agents in this setting.…”

mentioning

confidence: 99%

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Dudley¹,

Nightingale²,

Drezner³

et al. 1984

Antimicrob Agents Chemother

View full text Add to dashboard Cite

The penetration of cefonicid and cefazolin into cardiac tissue was compared after a single 30-mg/kg dose in 30 patients undergoing aortocoronary artery bypass graft surgery. Samples of the right atrial appendage, pericardial fluid, and serum were obtained at various times and assayed for drug content. The concentrations of cefonicid in serum and the atrial appendage were at least twice those observed for cefazolin at a given time after a dose. The mean (± standard deviation) atrial appendage-serum ratio was 0.47 ± 0.14 for cefonicid and 0.34 ± 0.06 for cefazolin (P < 0.005). Pericardial Cefonicid is a new cephalosporin with an antimicrobial spectrum similar to that of cefamandole except that it is less active against S. aureus and S. epidermidis. Cefonicid is excreted slowly by the kidneys, with a serum elimination half-life of ca. 4 h. High binding to serum proteins (96 to 98%) results in high concentrations in serum but also reduced the in vitro activity of this agent (6, 7). The high and prolonged concentrations in serum achieved after a single dose may allow for single-dose prophylaxis of infection during certain surgical procedures. In view of the pharmacokinetic properties of cefonicid and the potential usefulness of this agent in surgical prophylaxis, we compared the concentrations of cefonicid and cefazolin in serum, the right atrial appendage, and pericardial fluid of patients undergoing coronary artery bypass graft surgery.( the following were excluded from entry: total body weight (TBW) greater than lean body weight, +/-40%; renal dysfunction (serum creatinine greater than 1.5 mg/dl); history of a significant hypersensitivity reaction to a betalactam antibiotic; requirement for circulatory support (i.e., use of an intro-aortic balloon pump); or inability or refusal to give informed consent. There were two women in the cefonicid group and three women in the cefazolin group. The mean (+ standard deviation) total and ideal weights in the cefonicid group were 70 ± 11 and 66 ± 9 kg, respectively; in the cefazolin group, these weights were 75 ± 10 and 85 ± 10 kg, respectively. The mean preoperative serum creatinine was 1.0 ± 0.2 in the cefonicid group and 1.1 ± 0.2 in the cefazolin group. Each patient underwent a prestudy physical examination, gave a complete medical history, and had the following laboratory tests performed: complete blood count, blood urea nitrogen, serum creatinine, serum bilirubin, serum glutamic-oxaloacetic transaminase, and urinalysis. All of these tests were within the normal range in all patients.Dosing and sample collection. Patients were randomly distributed so as to receive a single 30-mg/kg TBW dose of either cefonicid or cefazolin intravenously over 5 min before surgery. Additional antimicrobial agents were withheld until after the collection of serum and tissue samples. One to three serum samples were collected from each patient during surgery before cardiopulmonary bypass. Blood samples were centrifuged at 3,250 x g for 10 min, and the serum was harvested. Pericardial fluid ...

show abstract

Antibiotic Prophylaxis in Surgical Procedures

Cited by 148 publications

References 113 publications

Amoxycillin and Clavulanic Acid versus Cefotaxime and Metronidazole as Antibiotic Prophylaxis in Elective Colorectal Resectional Surgery

Amoxycillin and Clavulanic Acid versus Cefotaxime and Metronidazole as Antibiotic Prophylaxis in Elective Colorectal Resectional Surgery

Standards of Antibiotic Prophylaxis in Abdominal Surgery

Comparative penetration of cefonicid and cefazolin into the atrial appendage and pericardial fluid of patients undergoing open-heart surgery

Contact Info

Product

Resources

About