Prophylactic postoperative antibiotics; a controlled study of 1007 cases

J, Barnes; Pace, William G.; Trump, David S.; Ellison, Edwin H.

doi:10.1097/00006534-195911000-00030

Cited by 5 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Previous clinical trials have failed to demonstrate any influence on wound infection when antibiotics are started after operation (McKittrick and Wheelock, 1954;Barnes et al, 1959), and experiments in animals have demonstrated that to provide effective prophylaxis against wound infections the antibiotic must be present in the tissues at the time of operation (Burke, 1961 ;Alexander-Williams and Altemeier, 1965). We therefore considered that if antibiotics were started more than 48 h after operation, it was unlikely that they would influence development of wound infection, and therefore such patients were not withdrawn from the study.…”

Section: Discussionmentioning

confidence: 99%

One-dose antibiotic prophylaxis against wound infection after appendicectomy: A randomized trial of clindamycin, cefazolin sodium and a placebo

Donovan

Ellis

Gatehouse

et al. 1979

Journal of British Surgery

View full text Add to dashboard Cite

Two hundred and fifty patients were admitted to a prospective randomized trial of single dosage prophylaxis against wound infection after appendicectomy. There were 12 exclusions, 72 patients received placebo, 81 received 600 mg i.m. clindamycin phosphate and 85 received 1 1 g i.m. cefazolin sodium, the agent being given in the anaesthetic room. Clindamycin produced a significant reduction in the overall rate of wound infection from 33 per cent in the controls to 17 per cent. In cases with a gangrenous or perforated appendix the infection rate in controls was 78 per cent; this was reduced to 44 per cent by a single dose of clindamycin. Cefazolin significantly reduced the number of aerobic organisms isolated from wound infections, but did not significantly reduce the incidence of wound infection. We conclude that anaerobic organisms are more important than faecal aerobic organisms in the pathogenesis of wound infection after appendicectomy.

show abstract

Section: Discussionmentioning

confidence: 99%

One-dose antibiotic prophylaxis against wound infection after appendicectomy: A randomized trial of clindamycin, cefazolin sodium and a placebo

Donovan

Ellis

Gatehouse

et al. 1979

Journal of British Surgery

View full text Add to dashboard Cite

show abstract

“…Firstly, systemic antibiotics have been used in several large trials, but, despite the occasional enthusiastic report (Bernard and Cole, 1964), are generally thought to be ineffective (Barnes et al, 1959;Karl et al, 1966;Report of Ad Hoc Committee, 1964). Cole and Bernard (1961) investigated the use of systemic antibiotics specifically in acute appendicitis and found that such treatment had no value in preventing postoperative wound sepsis.…”

Section: Discussionmentioning

confidence: 99%

Topical ampicillin in the appendicectomy wound: Report of double-blind trial

Rickett¹,

Jackson²

1969

BMJ

View full text Add to dashboard Cite

Summary: One hundred and thirty unselected patients undergoing appendicectomy were treated with topical ampicillin powder or topical placebo powder (lactose) before closing the wound. The postoperative wound infection rates were 3% in the ampicillin-treated group and 24% in the control group, a significant difference.This difference was not influenced by the degree of inflammation in the appendix. No side-effects of treatment were observed.

show abstract

“…The types of wounds evaluated were the follow¬ ing: (1) bone cases without foreign body implanta¬ tion; (2) soft tissue cases; (3) foreign body implan¬ tation; (4). "dirty" cases-infected, open fractures, foreign bodies.…”

Section: Methodsmentioning

confidence: 99%

A Study of Neomycin Instillation Into Orthopedic Surgical Wounds

Nachamie¹

1968

JAMA

View full text Add to dashboard Cite

The use of parenterally administered antibiotics preoperatively and postoperatively in orthopedic procedures has not proved significantly effective in preventing postoperative infection. This present controlled study (466 patients in a 28-month period) investigated the effect of local neomycin sulfate irrigation of orthopedic surgical wounds before closure on postoperative wound healing and complications. By the technique of irrigation and the doses of neomycin sulfate instilled into the wound (100 cc of 0.1% solution), there was no evidence that the antibiotic significantly altered the rate of infection or wound healing in osseous or soft tissue orthopedic wounds with or without metal implants.In the past 25 years the possibility of surgery, free from infection, has become a more and more attainable goal. Since the introduction of antibi¬ otics, the orthopedist, faced with wound infection and osteomyelitis, has reached for this goal as Tan¬ talus reached for his fruit tree. The closer the goal seems, the farther away it becomes.The most promising approach was postoperative prophylactic antibiotic therapy. Barnes1 in 1959 studied 1,007 consecutive surgical cases. Every other month, all postsurgical patients were given a combination of penicillin benzathine V and dihydrostreptomycin while in the recovery room. An "infective complication" rate of 9.8% was found without antibiotics and a rate of 11.4% with anti¬ biotics. Infective complications included pneumonia and phlebitis as well as wound infection. The rate of wound infection was 2.7% without antibiotics and 8.9% with antibiotics. Not only was there no decrease in the infection rate, but 76% of the infec¬ tions in the antibiotic-treated group were resistant to penicillin and streptomycin. Only 22% of the in¬ fections in the nontreated group were resistant. Several similar studies in the 1950's failed to show any beneficial effect of prophylactic antibi¬ otic therapy.In 1957 Tachdjian and Compere2 reviewed the records of 3,000 consecutive "clean" orthopedic op¬ erations. Major infection occurred in 1.89% of 1,900 operations when antibiotics were used prophylactically. In 1,100 operations without prophy¬ lactic antibiotics, 0.74% of the wounds became infected. When antibiotics were given prophylactically, most of the infections were caused by resis¬ tant organisms.Another approach to the prophylaxis of wound infection has been the irrigation of wounds with various antibiotic and antiseptic solutions. Single¬ ton3 studied the effect of several solutions on experi¬ mentally induced infection in guinea pigs. By smear¬ ing wounds with a human feces homogenate, an infection rate of 83% was produced. Irrigations with saline, sulfonamides oxychlorosene (Chlorpactin), and iodine all reduced the infection rate sig¬ nificantly. Neomycin alone, reduced the infection rate to a level comparable with the clean wound. Irrigation of a wound with neomycin also reduced the infection rate in distant wounds of the same guinea pig. Singleton's study made neomycin seem the ideal anti...

show abstract

Prophylactic postoperative antibiotics; a controlled study of 1007 cases

Cited by 5 publications

References 0 publications

One-dose antibiotic prophylaxis against wound infection after appendicectomy: A randomized trial of clindamycin, cefazolin sodium and a placebo

One-dose antibiotic prophylaxis against wound infection after appendicectomy: A randomized trial of clindamycin, cefazolin sodium and a placebo

Topical ampicillin in the appendicectomy wound: Report of double-blind trial

A Study of Neomycin Instillation Into Orthopedic Surgical Wounds

Contact Info

Product

Resources

About