Single-dose cefuroxime with gentamicin reduces Clostridium difficile-associated disease in hip-fracture patients

Converting Emergency Pilonidal Abscess Into an Elective Procedure

“…20,22 The incidence of CDI following cephalosporin ranges between 0.6% 22 and 4.2%. 23 The risk of CDI following cephalosporin, however, seems to be significantly less when combined with other antibiotics, 23 and, indeed, this was the regimen followed during this study. Although empirical, the choice of antibiotic regimen in this cohort was based on our previous experience from culture and sensitivity studies.…”

Changing Prophylactic Antibiotic Protocol for Reducing Clostridium Difficile—Associated Diarrhoeal Infections

“…This finding is consistent with a study using a single dose of cefuroxime with gentamicin as prophylactic antibiotics for proximal femoral fractures. 19 Hospitals or countries that enforce low usage of cephalosporins (through education, strict antibiotic policies coupled with prescribing penalties) result in lower rates of infections with multiple-resistant organisms. [20][21][22][23][24] Change of antibiotic prescribing practices demands a strong microbiology presence, robust antibiotic policies, education and laboratory support, as well as a careful evaluation of infected patients and potential pathogens (whether or not confirmed).…”

Clinical practice guidelines for antimicrobial prophylaxis in surgery

“…Success in decreasing rates of C. difficile-associated disease and mortality was seen in a single-center study with the antimicrobial prophylaxis regimen change from three doses of cefuroxime 790,792 to a single preoperative dose of cefuroxime plus gentamicin. 792 In another study, C. difficile-associated disease decreased after the prophylaxis regimen was changed from cefuroxime to amoxicillin-clavulanate. 790 Clindamycin and vancomycin have adequate activity against the most common pathogens involved in orthopedic procedures and would be acceptable alternatives under certain circumstances, such as prophylaxis for patients with a b-lactam allergy.…”

“…These agents are not recommended for routine use due to their higher cost, potential to promote resistance, and association with adverse events (e.g., C. difficileassociated diarrhea). 8,790,792 Alternative regimens may be needed for institutions with highly resistant organisms, such as MRSA or C. difficile. Success in decreasing rates of C. difficile-associated disease and mortality was seen in a single-center study with the antimicrobial prophylaxis regimen change from three doses of cefuroxime 790,792 to a single preoperative dose of cefuroxime plus gentamicin.…”