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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

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

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 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

The incidence of transient bacteremia following esophageal variceal sclerotherapy (EVS) was evaluated in 29 patients. These 29 patients underwent a total of 83 sclerotherapy sessions.Prior to EVS, all instruments were sterilized. Blood cultures were drawn pre-EVS and post-EVS.All pre-EVS and post-EVS blood cultures were negative. In conclusion, it was found bacteremia following sclerotherapy is not easily developed, if a vigorous approach of using well cleaned equipment is used. Unless there is a cardiac prothesis or valvular heart disease, antibiotic prophylaxis is not warranted.
Antibiotic Prophylaxis ; Bacteremia* ; Esophageal and Gastric Varices* ; Heart Valve Diseases ; Humans ; Incidence ; Sclerotherapy*

Vertebroplasty and kyphoplasty are well-known, useful techniques for the treatment of painful vertebral compression fractures. Although the risk associated with these procedures is low, serious complications can occur. Of these complications, infection is even rarer, however, when it does occur, it is difficult to manage and can become life-threatening. We describe here a case of infectious spondylitis with epidural inflammation that occurred after performing kyphoplasty in a patient who had a thoracic vertebra compression fracture. We reviewed other case and literatures. Extreme asepsis of the operating theater, screening and treatment for systemic infection prior to the procedure, as well as the use of appropriate antibiotic prophylaxis are strongly recommended when conducting kyphoplasty to prevent infection.
Antibiotic Prophylaxis ; Asepsis ; Fractures, Compression ; Humans ; Inflammation ; Kyphoplasty* ; Mass Screening ; Spine ; Spondylitis* ; Vertebroplasty

PURPOSE: To report the outcomes of clinical analysis on the negative culture rate of normal ocular surface flora and the anterior chamber penetration after the preoperative prophylactic use of 0.3% tosufloxacin ophthalmic solution. METHODS: From July 2010 to June 2012, 38 eyes of 38 patients who were scheduled to receive intravitreal injection or cataract surgery were examined for bacterial culture positive rate using conjunctival scraping. The patients were treated with 0.3% tosufloxacin eyedrops preoperatively 5 times a day for 2 days before surgery. After the treatment, the bacterial culture negative rate based on conjunctival scraping was assessed to evaluate the drug efficacy. Of the 38 patients, 19 had cataract surgery. The concentration of tosufloxacin at anterior chamber was assessed in the 19 patients. Additionally, any side effects from the drug were monitored during the treatment. RESULTS: Among the 38 eyes, 21 eyes showed a bacterial culture positive rate before treatment. After the drug treatment, the bacterial culture negative rate was 57.1% (12/21). Coagulase-negative staphylococci were most frequently cultured in 15 (39%) of the 38 eyes before treatment and the negative rate of bacterial culture was 86.7% (13/15) after treatment. Average antibiotic residue concentrations in aqueous humor was 0.050 +/- 0.038 microg/mL. No side effects from the drug were reported during the experimental period. CONCLUSIONS: Although the 0.3% tosufloxacin eyedrops were not effective in all bacterial strains and showed relatively low penetration rate into the anterior chamber, they were effective in some gram positive organisms, particularly in coagulase-negative staphylococci of normal ocular surface flora.
Anterior Chamber ; Antibiotic Prophylaxis ; Aqueous Humor ; Cataract ; Humans ; Intravitreal Injections ; Ophthalmic Solutions

Endoscopic treatment is a minimally invasive treatment for managing patients with vesicoureteral reflux (VUR). Although several bulking agents have been used for endoscopic treatment, dextranomer/hyaluronic acid is the only bulking agent currently approved by the U.S. Food and Drug Administration for treating VUR. Endoscopic treatment of VUR has gained great popularity owing to several obvious benefits, including short operative time, short hospital stay, minimal invasiveness, high efficacy, low complication rate, and reduced cost. Initially, the success rates of endoscopic treatment have been lower than that of open antireflux surgery. However, because injection techniques have been developed, a recent study showed higher success rates of endoscopic treatment than open surgery in the treatment of patients with intermediate- and high-grade VUR. Despite the controversy surrounding its effectiveness, endoscopic treatment is considered a valuable treatment option and viable alternative to long-term antibiotic prophylaxis.
Antibiotic Prophylaxis ; Endoscopy ; Humans ; Length of Stay ; Operative Time ; United States Food and Drug Administration ; Vesico-Ureteral Reflux