Anti-Bacterial Agents* ; Neuromuscular Blockade* ; Sisomicin*

PURPOSE: Prophylactic antibiotics have been used in nonperforated appendicitis for preventing infection after an appendectomy. However, the duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. PURPOSE: The objective of this study was to identify the appropriate duration of prophylactic antibiotic therapy in nonperforated appendicitis by comparing the wound infection rates of two different antibiotic regimens, 24 hours of cephalosporin (cefoxitin) alone and 72 hours of cephalosporin (cefoxitin) with aminoglycoside (sissomicin). METHODS: One hundred thirty-four (134) patients of nonperforated appendicitis were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: 1) cefoxitin 1 g every 8 hours given intravenously for 24 hours and 2) cefoxitin 1 g every 8 hours given intravenously plus sissomicin 75 mg every 12 hours given intramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. RESULTS: Postoperative wound infections were detected in 3 cases (4.5%) of the 72-hour-treated group (n=66) whereas none occurred in the 24-hour-treated group (n=68). However, the difference in the rates of wound infections between the two groups was not statistically significant. Cost analysis identified a saving of 43,470 won per patient in the 24-hour-treated group. CONCLUSION: In nonperforated appendicitis cefoxitin administration alone for 24 hours is sufficient as a surgical prophylaxis.
Anesthesia ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis* ; Cefoxitin ; Costs and Cost Analysis ; Humans ; Korea ; Prospective Studies* ; Sisomicin ; Surgical Wound Infection ; Wound Infection

Aortic valve is usually involved in infective endocarditis. Aortic valve endocarditis produces destruction and perforation of leaflets and results in ring abscess, frequently. Less commonly, direct extension or infected aortic regurgitant jet can produce secondary involvement of anterior mitral leaflet (AML) and result in the formation of an aneurysm or perforation of AML. A 60-year-old woman was admitted to Kyung Hee University hospital because of a febrile illness and dyspnea. Transthoracic echocardiography (TTE) showed an aortic valve vegetation, an aneurysm of AML, and an eccentric jet of mitral regurgitation through AML. Transe-sophageal echocardiography (TEE) showed a perforation of AML. -streptococcus was isolated from blood culture. The patient was treated with Vancomycin and Sisomicin sulfate. On hospital day 21, heart failure was aggravated and emergent double valve replacement was done. The patient was recovered and discharged.
Abscess ; Aneurysm* ; Aortic Valve* ; Dyspnea ; Echocardiography ; Endocarditis* ; Female ; Heart Failure ; Humans ; Middle Aged ; Mitral Valve Insufficiency ; Sisomicin ; Vancomycin

A new sisomicin resistance gene sisR was cloned from sisomicin-producing Micromonospora inyoensis. The sisR fragment was obtained by PCR amplification. The primer pairs were designed based on grm gene sequence from gentamicin-producing Micromonospora purpurea. The template DNA was isolated from Micromonospora inyoensis. A series of different DNA fragments were amplified by PCR, which were sub-cloned to vector pUC19 for further identification. It was found that five specific transformants containing target DNA fragments could resist high concentrations of sisomicin (over 1000 microg/mL sisomicin). One of them designated as sisR, was then sequenced and the alignment among sisR and other related genes showed that sisR gene differs from any known genes. It was concluded that sisR gene is a sequence that has not been reported so far.
Anti-Bacterial Agents ; pharmacology ; Bacterial Proteins ; genetics ; Base Sequence ; Cloning, Molecular ; Drug Resistance, Microbial ; genetics ; Genes, Bacterial ; Micromonospora ; genetics ; Molecular Sequence Data ; Sisomicin ; pharmacology