No abstract available.
Antibiotic Prophylaxis

Anti-Bacterial Agents ; therapeutic use ; Antibiotic Prophylaxis ; Humans ; Intraoperative Care

Background and Objective: Antibiotic prophylaxis is used to prevent bacterial infections and rebleeding in cirrhosis patients with upper gastrointestinal bleeding (UGIB). However, the effects of various antibiotics on patients with UGIB are still being considered. This study aims to evaluate the effect of antibiotic prophylaxis on cirrhosis patients with UGIB. Methods: The studies were searched through databases of PubMed, ScienceDirect, Wiley Online Library, and CENTRAL from 2013 to 2023. We used Revman 5.4 to perform a meta-analysis. I2 statistics measured the heterogeneity test. The odds ratio (OR) and 95% confidence interval (CI) were used to assess the effect of antibiotic prophylaxis. Results: Twelve studies involving 14,825 cirrhosis patients were included in this study. Based on the meta-analysis, antibiotic prophylaxis significantly lowered the bacterial infection rate (OR: 0.29, 95%CI: 0.10 to 0.84, P = 0.02), and the incidence of serious adverse events (SAE) (OR: 0.50, 95%CI: 0.28 to 0.88, P = 0.02) in cirrhosis patients with UGIB. Conclusions Administration of antibiotics demonstrated a significant reduction in bacterial infection rates and SAEs. Broad-spectrum non-absorbable antibiotics can be used in cirrhosis patients with UGIB. The appropriate use of antibiotics is important to prevent resistance.
Antibiotic ; Anti-Bacterial Agents ; prophylaxis ; prevention & ; control ; Cirrhosis ; Fibrosis

PURPOSE: We investigated the relationship of vesicoureteral reflux (VUR) and renal scarring in children who were treated surgically due to failure of initial medical management. MATERIALS AND METHODS: Thirty two children (51 renal units), 15 boys and 17 girls, aged 1-8 (median 3.2) years, with VUR were analyzed retrospectively. All children were initially treated with antibiotic prophylaxis for median 15.2 months (10-19 months). In 51 renal units, reflux grade at presentation was grade II in 8, III in 14, IV in 25 and V in 4. Renal scars were evaluated with dimercaptosuccinic acid (DMSA) scan and classified into three grades. We analyzed the incidence and severity of renal scar according to various clinical characteristics and discussed the optimal treatment in vesicoureteral reflux with respect to the development of renal scar. RESULTS: DMSA scan revealed that 69% (35/51) of the renal units had renal scars. Scarring at presentation was grade I in 10, II in 20 and III in 5 renal units. The incidence of renal scar was 86% at ages less than 2 years, 72% at ages 2 to 5 and 27% at ages greater than 5, of which the difference was statistically significant. And the incidence of renal scar according to the reflux grade was 38% in II, 50% in III, 84% in IV and 100% in V, of which the differnce was also statistically significant. However, the sex and laterality did not affect the incidence of renal scar in this study. With respect to the scar grade, the grade of refux was the only statistically significant determining factor. Especially, grade IV reflux resulted in much more severe scarring than grade III reflux. Comparing the result of DMSA scan at presentation with that just before operation in 13 children (18 renal units), only two renal units with grade IV reflux showed increase in renal scar. CONCLUSIONS: The most important factor to affect the development and severity of renal scar was the reflux grade. Considering relatively higher incidence of renal scar and more severe scarring in grade IV reflux than grade III reflux, early surgical management may be a possible option in the treatment of children with grade IV reflux.
Antibiotic Prophylaxis ; Child ; Cicatrix* ; Female ; Humans ; Incidence ; Retrospective Studies ; Succimer ; Vesico-Ureteral Reflux*

PURPOSE: Although the two or three-postoperative doses of prophylactic antibiotics are recommended, the tendency for surgeons to prolong the administration of prophylactic antibiotics after colorectal surgery is a well-known fact. The aim of this study was to assess the prophylactic efficacy of two or three-doses of prophylactic antibiotics over a 24 hour period after elective colorectal surgery. METHODS: We reviewed the surgical complications in 69 patients who underwent elective colorectal surgery from April to Jun, 2006. All patients had preoperative mechanical bowel cleansing performed. As antibiotic prophylaxis, oral metronidazole was administered 2~3 times on the day before surgery and second generation cephalosporin were administered intravenously 30 minutes before surgical incision. After surgery, second generation cephalosporin, aminoglycoside and metronidazole were given to all the patients, at 2~3 doses for 24 hours. Wound conditions were checked on alternate days during the hospital stay and the patients were followed up for at least 30 days after discharge. RESULTS: In 69 patients, the diseases were cancer in 64 cases (92.8%). The procedures were anterior resection or lower anterior resection in 38 cases (55.1%), hemicoloectomy in 16 cases (23.2%), segmental resection in 9 cases, and abdomino-perineal resection or Hartmann's procedure in 6 cases. The wound complications were wound seroma in 3 cases (4.3%), wound dehiscence in 3 cases (4.3%) and anastomotic leakage in 1 case (1.4%). CONCLUSION: The wound complication rate was not high after antibiotic prophylaxis for 24 hours in patients who underwent elective colorectal surgery. Further studies are required to establish appropriate guidelines for antibiotic prophylaxis after elective colorectal surgery.
Anastomotic Leak ; Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Colorectal Surgery ; Humans ; Length of Stay ; Metronidazole ; Seroma

OBJECTIVE: The risk of complications is high for patients with a large cranial defect and hydrocephalus, undergoing cranioplasty and ventriculoperitoneal (VP) shunt operation. The purpose of this study is to examine retrospectively such cases with complications and contrive an operative technique to reduce complications. METHODS: Nineteen patients underwent cranioplasty and VP shunt operation due to large cranial defects and hydrocephalus. These patients were divided into two groups: Group A with 10 patients who underwent staged-operations, and Group B with 9 patients who underwent one-stage operation. Their complications in each group were retrospectively reviewed. Another five patients underwent a one-stage operation with temporary occlusion of the distal shunt catheter to improve on the technique and were categorized as Group C. Complications in these groups were compared and analyzed. RESULTS: The results of the data analysis revealed that complications related to anesthesia (40%) and those related to antibiotic prophylaxis (30%) were high in Group A, while non-infectious delayed complications (45%) and perioperative complications such as intracranial hematoma (33%) were high in Group B. However, for patients in Group C, it showed less complication with the operative technique devised by these authors, as opposed to two previous procedures. CONCLUSION: In patients with hydrocephalus and a large cranial defect, complications arising from existing one-stage operation or staged-operations can be reduced by implementing the technique of "one-stage operation with temporary occlusion of the distal shunt catheter."
Anesthesia ; Antibiotic Prophylaxis ; Catheters ; Decompressive Craniectomy ; Hematoma ; Humans ; Hydrocephalus* ; Retrospective Studies ; Statistics as Topic ; Ventriculoperitoneal Shunt*

PURPOSE: Although most surgeons generally administer prophylactic antibiotics for more than three days, the optimal duration of antimicrobial prophylaxis in elective gastric surgery is still open to debate. The aim of this study was to determine if the duration of prophylactic antibiotic use can affect the recovery of patients after elective gastric surgery. MATERIALS AND METHODS: A total of 93 patients with gastric cancer were enrolled in this study, between January 2007 and December 2007. Patients were excluded if they had an infection at the time of surgery or they underwent an emergency operation. The first antibiotics were commonly given from just prior to the operation. The patients were divided into three groups according to the operation periods: those who received antibiotics only on the day of operation (arm A), those who received antibiotics for up to 3 days (arm B), and those who received antibiotics for more than 5 days postoperatively (arm C). The antibiotic that was used was second generation cephalosporin. RESULTS: The rate of surgical site infection was 12.9% (n=4) in arm A, 16.1% (n=5) in arm B and 19.4% (n=6) in arm C, respectively (P=0.788). No relationship was observed between the duration of prophylaxis and the rate of fever or the neutrophil counts during postoperative 7 days (P=0.119, P=0.855). CONCLUSION: The prophylactic effect of antibiotics on recovery, with the antibiotics being received only on the day of the operation, is as effective as receiving antibiotics for a longer duration after gastric cancer surgery.
Anti-Bacterial Agents ; Antibiotic Prophylaxis ; Arm ; Emergencies ; Fever ; Gastrectomy ; Humans ; Neutrophils ; Stomach Neoplasms

PURPOSE: To evaluate practice patterns for pediatric hydronephrosis of Korean urologists practicing at secondary or university hospitals. MATERIALS AND METHODS: The subjects were asked to complete questionnaires sent by postal mail or e-mail that explored practicing diagnostic and therapeutic strategies in the management of pediatric hydronephrosis and ureteropelvic junction obstruction. The questionnaires of those responding were analyzed according to whether the respondent practiced at a secondary or university hospital, how long they had been urologists, and whether they specialized in pediatric urology or other specific field of urology. RESULTS: Of the 354 questionnaires sent, 97 were returned (response rate 27.4%). Voiding cystourethrography was not routinely recommended by 95.7% of respondents, and diuretic renal scanning was considered necessary for postnatal evaluation of prenatal hydronephrosis by 78.5%. In addition, 72.2% of these doctors did not routinely recommend antibiotic prophylaxis. Follow-up ultrasonography was recommended at 3 to 6 months (61.1%), and follow-up diuretic renal scanning was recommended at 3 to 6 months (38.6%) or 6 to 12 months (32.7%). The reported length of time it took to deem an operation as a success was 3 to 6 months (49.5% and 60.7%) and within 3 months (34.1% and 19.1%) by ultrasonography and diuretic renal scanning, respectively. CONCLUSIONS: This survey documented a certain degree of variability among Korean urologists concerning standard practices of the assessment, follow-up, and treatment for pediatric hydronephrosis. Results from this survey might contribute useful data for establishing proper guidelines for the management of pediatric hydronephrosis.
Antibiotic Prophylaxis ; Surveys and Questionnaires ; Electronic Mail ; Follow-Up Studies ; Hospitals, University ; Hydronephrosis ; Pediatrics ; Postal Service ; Urology

Antibiotic Prophylaxis ; Child ; Female ; Humans ; Male ; Vesico-Ureteral Reflux ; prevention & control

BACKGROUND AND AIMS: Prophylactic antibiotics are used in an attempt to avoid the septic complications of endoscopic retrograde cholangiopancreatography (ERCP). But, there is individual tendency to choose prophylactic antibiotics due to a lack of definite guidelines for prophylactic antibiotics. Therefore, the effectiveness of ciprofloxacin to prevent post ERCP infectious complications was evaluated. METHODS: One hundred patients underwent 75 diagnostic ERCPs and 25, therapeutic ERCPs. They were classified randomly into a group of 51 prophylaxis (ciprofloxacin 200 mg i.v. 30 min before the procedure) and 49 controls. Pre- and post-ERCP blood cultures were prospectively performed and surveyed for infectious complications. RESULTS: Sepsis was detected in 4 patients in each group (p>0.05). Two cases were related to diagnostic ERCP and the remaining six cases, therapeutic ERCP (p<0.01). Bacteremia was found in 6 cases, but only two cases (Escherichia coli, Citrobacter freundii) were clinically significant. CONCLUSIONS: The frequency of sepsis following ERCP was not significantly reduced by antibiotic prophylaxis (7.8% vs. 8.2%).
Anti-Bacterial Agents ; Antibiotic Prophylaxis* ; Bacteremia ; Cholangiopancreatography, Endoscopic Retrograde* ; Ciprofloxacin ; Citrobacter ; Humans ; Prospective Studies ; Sepsis