amoxicillin-potassium-clavulanate-combination and Postoperative-Complications

Risk of methicillin-resistant Staphylococcus aureus (MRSA) infection after surgery is generally low, but affects up to 33% of patients after certain types of surgery. Postoperative MRSA infection can occur as surgical site infections (SSIs), chest infections, or bloodstream infections (bacteraemia). The incidence of MRSA SSIs varies from 1% to 33% depending upon the type of surgery performed and the carrier status of the individuals concerned. The optimal prophylactic antibiotic regimen for the prevention of MRSA after surgery is not known.. To compare the benefits and harms of all methods of antibiotic prophylaxis in the prevention of postoperative MRSA infection and related complications in people undergoing surgery.. In March 2013 we searched the following databases: The Cochrane Wounds Group Specialised Register; The Cochrane Central Register of Controlled Trials (CENTRAL); Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); NHS Economic Evaluation Database (The Cochrane Library); Health Technology Assessment (HTA) Database (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; and EBSCO CINAHL.. We included only randomised controlled trials (RCTs) that compared one antibiotic regimen used as prophylaxis for SSIs (and other postoperative infections) with another antibiotic regimen or with no antibiotic, and that reported the methicillin resistance status of the cultured organisms. We did not limit our search for RCTs by language, publication status, publication year, or sample size.. Two review authors independently identified the trials for inclusion in the review, and extracted data. We calculated the risk ratio (RR) with 95% confidence intervals (CI) for comparing binary outcomes between the groups and planned to calculated the mean difference (MD) with 95% CI for comparing continuous outcomes. We planned to perform meta-analysis using both a fixed-effect model and a random-effects model. We performed intention-to-treat analysis whenever possible.. We included 12 RCTs, with 4704 participants, in this review. Eleven trials performed a total of 16 head-to-head comparisons of different prophylactic antibiotic regimens. Antibiotic prophylaxis was compared with no antibiotic prophylaxis in one trial. All the trials were at high risk of bias. With the exception of one trial in which all the participants were positive for nasal carriage of MRSA or had had previous MRSA infections, it does not appear that MRSA was tested or eradicated prior to surgery; nor does it appear that there was high prevalence of MRSA carrier status in the people undergoing surgery.There was no sufficient clinical similarity between the trials to perform a meta-analysis. The overall all-cause mortality in four trials that reported mortality was 14/1401 (1.0%) and there were no significant differences in mortality between the intervention and control groups in each of the individual comparisons. There were no antibiotic-related serious adverse events in any of the 561 people randomised to the seven different antibiotic regimens in four trials (three trials that reported mortality and one other trial). None of the trials reported quality of life, total length of hospital stay or the use of healthcare resources. Overall, 221/4032 (5.5%) people developed SSIs due to all organisms, and 46/4704 (1.0%) people developed SSIs due to MRSA.In the 15 comparisons that compared one antibiotic regimen with another, there were no significant differences in the proportion of people who developed SSIs. In the single trial that compared an antibiotic regimen with placebo, the proportion of people who developed SSIs was significantly lower in the group that received antibiotic prophylaxis with co-amoxiclav (or cefotaxime if allergic to penicillin) compared with placebo (all SSI: RR 0.26; 95% CI 0.11 to 0.65; MRSA SSI RR 0.05; 95% CI 0.00 to 0.83). In two trials that reported MRSA infections other than SSI, 19/478 (4.5%) people developed MRSA infections including SSI, chest infection and bacteraemia. There were no significant differences in the proportion of people who developed MRSA infections at any body site in these two comparisons.. Prophylaxis with co-amoxiclav decreases the proportion of people developing MRSA infections compared with placebo in people without malignant disease undergoing percutaneous endoscopic gastrostomy insertion, although this may be due to decreasing overall infection thereby preventing wounds from becoming secondarily infected with MRSA. There is currently no other evidence to suggest that using a combination of multiple prophylactic antibiotics or administering prophylactic antibiotics for an increased duration is of benefit to people undergoing surgery in terms of reducing MRSA infections. Well designed RCTs assessing the clinical effectiveness of different antibiotic regimens are necessary on this topic.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Carrier State; Cefotaxime; Humans; Methicillin-Resistant Staphylococcus aureus; Postoperative Complications; Randomized Controlled Trials as Topic; Staphylococcal Infections; Surgical Wound Infection

We present a case of recurrent subdural post-surgical empyema by Proprionibacterium acnes after a first drained empyema in which no microbiological diagnosis was reached. P. acnes is a gram-positive anaerobic organism which is part of the saprophytic flora of the skin and others parts of the body. However, it can cause infections, as in the central nervous system, especially post-surgical infections in which can be the second more frequent organism after Staphylococcus aureus. P. acnes grows slowly and shows better growth in liquid anaerobic media. It is usually resistant to metronidazol and sensitive to penicillin. In postoperative central nervous system infections we must take into account the possibility of this organism, process the sample properly and keep touch with the Microbiology Department.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Combined Modality Therapy; Decompressive Craniectomy; Drainage; Drug Resistance, Microbial; Empyema, Subdural; Gram-Positive Bacterial Infections; Humans; Male; Meningeal Neoplasms; Meningioma; Metronidazole; Postoperative Complications; Propionibacterium acnes; Recurrence; Surgical Wound Dehiscence; Surgical Wound Infection

Nocardia transvalensis is a rarely reported cause of clinically significant disease, and, to our knowledge, has not been reported previously as a cause of infection in the cardiac transplant population. We report a case of N transvalensis new taxon-2 pulmonary infection that disseminated to the brain and skin in a cardiac transplant recipient despite adequate sulfonamide serum levels. Subsequent isolates were resistant to sulfonamides, and molecular ribotyping of the primary and subsequent isolates confirmed that these were the same N transvalensis new taxon-2 strain. The taxonomic and diagnostic considerations, as well as the clinical significance of anti-microbial-resistant nocardia, are reviewed and discussed herein.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cardiomyopathy, Dilated; Ceftriaxone; Ciprofloxacin; Drug Resistance; Heart Transplantation; Humans; Male; Middle Aged; Nocardia; Nocardia Infections; Outcome Assessment, Health Care; Postoperative Complications; Sulfonamides

The present study was designed to investigate the difference in the effectiveness of a 3 day postoperative course and a single perioperative dose of antibiotics on the incidence of postoperative infection in the management of maxillofacial trauma patients.. About 183 maxillofacial trauma patients requiring open reduction and internal fixation (ORIF) under general anesthesia were divided based on the type of fracture sustained, i.e., mandibular fractures, Le Fort fractures, and zygomaticomaxillary complex fractures. Patients from each fracture type were randomized into two groups, A and B. All patients were administered amoxicillin/clavulanate 1.2 grams intravenously 8 hours from the time of admission till the patient was taken up for surgery. Once the patients were taken up for surgery, a perioperative dose was administered. No antibiotics beyond this point were given to patients in Group A. Patients in Group B were administered the same antibiotic for 3 postoperative days additionally. Outcomes in terms of purulent discharge from the surgical site, an abscess or any other sign of infection, and wound dehiscence requiring reopening of the surgical site were considered. Patients were reviewed at 1 week, 2 weeks, 1 month, 2 months, and 3 months.. No statistically significant difference was found between the two groups across all three fracture types in terms of postoperative outcomes. However, increased numbers of complications were noted in the patients treated with an intra-oral approach in each fracture type irrespective of group. All complications were managed with local measures.. A single perioperative dose of antibiotics is effective in minimizing postoperative complications following ORIF of maxillofacial fractures and there is no significant benefit in prolonging the course of antibiotics postoperatively with the need for further studies to be conducted considering comminuted, complex fractures and old fractures.. In maxillofacial trauma, fractures frequently communicate with contaminated indigenous flora on the skin surface, oral cavities, or sinus cavities. Surgery is frequently performed using an approach across a contaminated area, even in closed fractures. Postoperative infections can be significantly decreased by using antibiotics in surgical procedures to treat facial fractures.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Humans; Mandibular Fractures; Postoperative Complications; Prospective Studies; Skull Fractures

To compare the effectiveness of different oral antibiotics for prevention of dry socket and infection in adults following the surgical extraction of teeth under LA.. This randomized controlled study was conducted from 10 September 2020 until 10 May 2021. Forty-six patients were randomly allocated to three groups. Sixteen patients were in the postoperative co-amoxiclav (625 mg) group, fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative metronidazole (500 mg) group and fifteen in the preoperative co-amoxiclav (625 mg) plus postoperative amoxicillin (500 mg) group. Evaluation of the postoperative signs of alveolar osteitis and infection was made by a dental surgeon five days postoperatively. Evaluation of the post-surgical extraction pain was made by patients immediately and five days postoperatively on standard 100 mm visual analogue scales (VAS). Furthermore, difficulty of surgery was recorded for all patients immediately postoperatively using (VAS).. all antibiotics used in this study were effective. Only 15% of patients had painful alveolar osteitis and 2% had oral infections. There was no significant decrease in the number of patients with severe alveolar osteitis or infection for co-amoxiclav plus metronidazole and co-amoxiclav plus amoxicillin groups compared to co-amoxiclav group at 5 days post-operation (. Administration of a single preoperative dose of co-amoxiclav with a full postoperative dose of amoxicillin or metronidazole was more effective than conventional treatment with postoperative co-amoxilcalv in reducing the incidence of both alveolar osteitis and infection after surgical extractions. However, these differences were not statistically significant. Interestingly, patients in metronidazole group had the lowest incidence of dry socket.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Dry Socket; Humans; Metronidazole; Molar, Third; Pain, Postoperative; Postoperative Complications

To compare postoperative infection and graft uptake rate using single dose of intravenous co-amoxiclav versus no antibiotic in children undergoing myringoplasty.. This is a prospective, randomized controlled study conducted in children of age 6-15 years with chronic otitis media (COM) mucosal, inactive type undergoing myringoplasty. Postoperative infection over a period of 4 weeks and status of graft at or around 3 months after surgery was studied as outcome measure.. Fifty five out of sixty children completed follow-up. The overall postoperative infection rate was 5.4%. Postoperative infection rate was 3.5% in children receiving prophylactic antibiotic and 7.4% in children receiving no antibiotic. There was no statistically significant difference in postoperative infection between two groups (P > 0.05). The overall graft uptake rate was 87.27%. It was 85.7% in antibiotic used group and 88.8% in non-antibiotic group with no statistically significant difference (P > 0.05).. Postoperative infection following myringoplasty in children is uncommon as it is a clean type of surgery. There was no statistically significant difference in postoperative infection and graft uptake rate by the use of prophylactic antibiotic in the intraoperative period. This study shows no benefit of a prophylactic antibiotic on postoperative infection or graft success in myringoplasty in children.. NCT03700814.

Topics: Administration, Intravenous; Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Child; Chronic Disease; Female; Follow-Up Studies; Humans; Male; Myringoplasty; Otitis Media; Postoperative Complications; Prospective Studies; Treatment Outcome; Tympanic Membrane Perforation

Tooth extraction is a very common procedure in oral surgery. Despite this, very little information is available in the literature as to the antibiotic management of the patient. The aim of this study is to evaluate whether the antibiotic prophylaxis could be beneficial in preventing postextraction local complications and whether the use of a probiotic could help reduce the antibiotic gastro-intestinal side effects.. One hundred eleven patients meeting the inclusion criteria were initially included in this randomized clinical trial and randomly allocated to one of the three experimental groups according to a computer-generated randomization list. Patients allocated to the group 1 were given amoxicillin+clavulanic acid (2 g/day for 6 days), patients allocated to the group 2 received antibiotic + probiotic (Bifidobacterium longum+lactoferrin) and patients allocated to the group 3 received no antibiotic therapy after the extraction. To evaluate post-extractive complications, controls were performed at days 7, 14 and 21 after the extraction.. At T1 pain at the surgical site was present in the 48%, 30% and 71.4% of the patients belonging respectively to the antibiotic alone group, to the antibiotic+probiotic group and to the control group. The mean Numeric Rating Score (NRS) score was 1.56±1.91, 1.08±1.93, 2.02±2.27 respectively (P=0.0498). Two patients belonging to the control group experienced dry socket. In addition, 9 patients (33.3%) in the antibiotic-alone group and 1 patient (2.7%) in the antibiotic+probiotic group reported intestinal distension (P=0.0012), 7 days after surgery. Finally, diarrhea was recorded in 5 patients of the antibiotic alone group (18.5%), on the other hand, no patients of the antibiotic+probiotic group and the control group reported diarrhea.. Postextractive complications observed in each group have been mild and fast to resolve. The antibiotic administration showed a decrease in pain suffered by patients but a higher incidence of gastrointestinal side effects, such as abdominal distension and diarrhea, which seemed to be relieved by the concomitant use of the probiotic.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Antibiotic Prophylaxis; Bifidobacterium longum; Diarrhea; Dry Socket; Female; Humans; Ibuprofen; Lactoferrin; Male; Middle Aged; Pain, Postoperative; Postoperative Complications; Probiotics; Surgical Wound Infection; Tooth Extraction; Treatment Outcome

The purpose of this study was to compare the use of amoxicillin (1g) vs amoxicillin and clavulanate (875/125mg) after extraction of retained third molars for prevention of infectious complications.. The study involved 546 patients attending for removal a retained third molar and divided in to two groups: Group 1 - amoxicillin and clavunate (875/125mg) group (n=257) and Group 2 - amoxicillin (1g) group (n=289). All patients were recalled for investigating the possibility of infection, presence of diarrhea and further analgesic intake.. From a total of 546 patients, the frequency of infection was 1.4%, without no statistically differences between the two groups. Group 1 showed statistically higher presence of patients with gastrointestinal complications (p>0.05). In 546 patients, 2.7% of patients reported severe pain that would not relieve with medication.. The results of our study show that the use of amoxicillin (1g) and amoxicillin and clavunate (875/125mg) is similar efficacious in preventing infection after retained third molar extraction but amoxicillin and clavunate (875/125mg) produces more gastrointestinal discomfort.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; beta-Lactamase Inhibitors; Female; Humans; Male; Molar, Third; Postoperative Complications; Tooth Extraction

Ninety percent of cases of acute calculous cholecystitis are of mild (grade I) or moderate (grade II) severity. Although the preoperative and intraoperative antibiotic management of acute calculous cholecystitis has been standardized, few data exist on the utility of postoperative antibiotic treatment.. To determine the effect of postoperative amoxicillin plus clavulanic acid on infection rates after cholecystectomy.. A total of 414 patients treated at 17 medical centers for grade I or II acute calculous cholecystitis and who received 2 g of amoxicillin plus clavulanic acid 3 times a day while in the hospital before and once at the time of surgery were randomized after surgery to an open-label, noninferiority, randomized clinical trial between May 2010 and August 2012.. After surgery, no antibiotics or continue with the preoperative antibiotic regimen 3 times daily for 5 days.. The proportion of postoperative surgical site or distant infections recorded before or at the 4-week follow-up visit.. An imputed intention-to-treat analysis of 414 patients showed that the postoperative infection rates were 17% (35 of 207) in the nontreatment group and 15% (31 of 207) in the antibiotic group (absolute difference, 1.93%; 95% CI, -8.98% to 5.12%). In the per-protocol analysis, which involved 338 patients, the corresponding rates were both 13% (absolute difference, 0.3%; 95% CI, -5.0% to 6.3%). Based on a noninferiority margin of 11%, the lack of postoperative antibiotic treatment was not associated with worse outcomes than antibiotic treatment. Bile cultures showed that 60.9% were pathogen free. Both groups had similar Clavien complication severity outcomes: 195 patients (94.2%) in the nontreatment group had a score of 0 to I and 2 patients (0.97%) had a score of III to V, and 182 patients (87.8%) in the antibiotic group had a score of 0 to I and 4 patients (1.93%) had a score of III to V.. Among patients with mild or moderate calculous cholecystitis who received preoperative and intraoperative antibiotics, lack of postoperative treatment with amoxicillin plus clavulanic acid did not result in a greater incidence of postoperative infections.. clinicaltrials.gov Identifier: NCT01015417.

Topics: Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Cholecystectomy; Cholecystitis, Acute; Female; Humans; Male; Middle Aged; Postoperative Care; Postoperative Complications; Treatment Outcome; Young Adult

The objectives are to assess the efficacy of antibiotics in reducing post-tonsillectomy morbidities in children. This is a clinical trial study that was undertaken at the Jordan University Hospital during the period from June 2008 to July 2009. All patients undergoing tonsillectomy were randomly divided into two matched groups on alternating basis: group A included patients who received antibiotics (amoxicillin with clavulanic acid) for 5 days in the post-tonsillectomy period and group B included patients who received none. The two groups were compared with respect to fever, secondary bleeding, throat pain, and the time to resume to normal diet. Bleeding was more common in group A (5.5 %) than in group B (2 %). The average duration of throat pain was 4.2 days in group A, while it was 3.9 days in group B. The average time to resume normal diet was 5.7 days in group A, whereas it was 5.3 days in group B. Fever was noted in 17 (31 %) patients from group A, while it was observed in 15 (30 %) patients from group B. The use of antibiotics in the post-tonsillectomy period does not reduce post-operative morbidity in children and therefore it is advised to use antibiotics on an individual basis rather than routinely for patients undergoing tonsillectomy.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Child; Child, Preschool; Female; Humans; Male; Postoperative Complications; Tonsillectomy; Treatment Outcome

To assess the prevalence of infectious complications and the protective effect of prophylactic antibiotic treatment after diagnostic office hysteroscopy in asymptomatic, infertile patients with normal results from transvaginal sonography.. Recording of infectious complications after routine hysteroscopy in the context of a randomized controlled trial; pseudorandomized, center-specific application of antibiotic prophylaxis.. Two tertiary infertility care units.. Six hundred thirty-one unselected, asymptomatic, infertile women who underwent routine, diagnostic hysteroscopy prior to a first in vitro fertilization (IVF) or intracytoplasmic sperm injection treatment.. Depending on the hospital and according to local protocols, hysteroscopy was performed with or without antibiotic prophylaxis.. The prevalence of infectious complications after routine hysteroscopy.. Of the 631 women who underwent routine, diagnostic hysteroscopy, antibiotic prophylaxis was prescribed to 266 women, whereas 365 women underwent the procedure without prophylaxis. Only one infectious complication occurred (0.4%) in a patient who had not undergone therapeutic interventions and had taken antibiotic prophylaxis. This complication was successfully treated with antibiotics on an outpatient basis.. Considering the extremely low risk of infectious complications and the lack of evidence, suggesting a beneficial effect of antibiotic prophylaxis, its use for routine, diagnostic office hysteroscopy should not be recommended.

Topics: Adult; Ambulatory Care; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Communicable Diseases; Doxycycline; Female; Humans; Hysteroscopy; Infertility, Female; Postoperative Complications; Prevalence; Uterus

Postbronchoscopy fever can develop in 5-16% of adult patients. The microbiological contribution to postbronchoscopy fever is unclear.. To elucidate the effect of prophylactic antibiotics on the development of postbronchoscopy fever and pneumonia.. Study patients were randomised to receive no treatment or oral amoxicillin/clavulanate 30 min before flexible bronchoscopy. The primary outcome variable was the frequency of postbronchoscopy fever and pneumonia. White blood cell counts, C-reactive protein and the serum pyrogenic cytokines interleukin (IL) 1β, IL-6 and tumour necrosis factor-alpha were measured before and after bronchoscopy.. Of 143 subjects enrolled in the study, the final analysis was performed among 67 subjects in the prophylaxis group and 64 in the control group. The frequency of postbronchoscopy fever did not differ between the groups (25.4% for the prophylaxis group vs. 26.6% for controls, P > 0.05). Pneumonia developed in 1.5% of the prophylaxis group and 4.7% of the controls. There was no bacteraemia in either group. Serum pyrogenic cytokines did not differ between the groups.. Prophylactic antibiotics before bronchoscopy did not reduce the frequency of postbronchoscopy fever and did not affect serum levels of pyrogenic cytokines. These findings suggest that microbiological factors may not be responsible for the development of postbronchoscopy fever.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bronchoscopy; Cytokines; Female; Fever; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Single-Blind Method; Young Adult

The present study was designed to evaluate the prophylactic efficacy after the correction of dentofacial deformities between short- and long-term penicillin and amoxicillin-clavulanic acid.. The present study was prospective, randomized, and double blinded. Patients were separated into four groups randomly: short-term and long-term (5 days) penicillin and short-term and long-term (5 days) amoxicillin-clavulanic acid.. One hundred twenty two patients were assigned randomly into the four groups. Infection developed in a patient in the short-term amoxicillin-clavulanic acid group and in a patient in the long-term penicillin group.. There were no differences in infection between the two groups of antibiotics. Based on the present study, short-term penicillin is still the most appropriate choice for prophylactic antibiotic in orthognathic surgery.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Infections; Double-Blind Method; Drug Therapy, Combination; Female; Humans; Male; Osteotomy; Penicillins; Postoperative Complications; Preoperative Care; Prognathism; Prospective Studies; Temporomandibular Joint; Young Adult

The most common complications after surgical extraction of the third mandibular molar are trismus, oedema or swelling, local pain, dysphagia and infection. The aim of this comparative, double-blind, randomized clinical trial was to evaluate the efficacy of two sustained release amoxicillin/clavulanate regimens in the reduction of infection after third molar extractive surgery. A total of 225 patients were randomized into three equal groups: placebo, prophylaxis with single pre-surgical dose of two tablets amoxicillin/clavulanate 1000/62.5 mg, and pre-emptive post-surgery therapy with two tablets amoxicillin/clavulanate 1000/62.5 mg BID for 5 days. A higher rate of infection (P=0.006) was found among patients receiving placebo (16%) than those receiving single-dose prophylaxis (5.3%) or 5-day pre-emptive therapy (2.7%). A relationship between both the duration (13.8% for long versus 7.4% for medium versus 1.6% for short) and difficulty (12.7% with ostectomy versus 3.5% without ostectomy; P=0.011) of surgical procedure and incidence of subsequent infection was also observed. Both prophylactic and therapeutic regimens versus placebo achieved greater reduction of pain after surgery on day 3 (P=0.001). Logistic regression analysis revealed a risk of infection of 24%, 9% and 4% for ostectomy with placebo, prophylaxis and pre-emptive treatment, respectively, whereas it was 7%, 2% and 1% if ostectomy was not performed. Pre-emptive therapy with the oral sustained release amoxicillin/clavulanate formulation reduced the rate of subsequent infection in patients undergoing ostectomy. Prophylaxis was beneficial in simpler procedures and may be indicated in cases where ostectomy is not performed.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Case-Control Studies; Deglutition Disorders; Delayed-Action Preparations; Double-Blind Method; Edema; Female; Fever; Humans; Male; Middle Aged; Molar, Third; Osteotomy; Pain, Postoperative; Placebos; Postoperative Complications; Risk Factors; Surgical Wound Infection; Tooth Extraction; Treatment Outcome; Trismus

Perioperative antibiotic prophylaxis has significantly reduced wound infection rates in clean-contaminated head and neck surgical procedures but controversy still remains regarding the optimal antibiotic regime.. To examine the efficacy of different antibiotics in head and neck oncological surgery prophylaxis.. In this prospective, double-blind clinical trial, 189 patients with carcinoma of the upper aerodigestive tract were randomized to receive amoxicillin-clavulanate or cefazolin intravenously up to 1h before surgery and at 8-h intervals for an additional three doses.. An overall wound infection rate of 22% was observed. The infection rate in patients receiving cefazolin was 24% (22/92) vs. 21% (20/97) in those receiving amoxicillin-clavulanate; the difference was not statistically significant. Postoperative overall non-wound infection developed in 12% (22/189) patients; the rate of infection was 9.8% (9/92) in patients receiving cefazolin vs. 13.4% (13/97) in those receiving amoxicillin-clavulanate, without a statistically significant difference between the two groups. Gram-negative bacteria were more often isolated with Pseudomonas aeruginosa as the dominant species. The risk of postoperative infection was more influenced by the type of surgical procedure than by disease stage.. In clean-contaminated head and neck oncologic surgery amoxicillin-clavulanate prophylaxis was at least as efficient as cefazolin. However, when taking into account the fact that beta-lactamase containing strains have recently been spreading, amoxicillin-clavulanate should be the logical first choice.

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bronchitis; Carcinoma, Squamous Cell; Cefazolin; Double-Blind Method; Head and Neck Neoplasms; Humans; Injections, Intravenous; Laryngeal Neoplasms; Mouth Neoplasms; Pharyngeal Neoplasms; Pneumonia, Bacterial; Postoperative Complications; Prospective Studies; Pseudomonas aeruginosa; Pseudomonas Infections; Staphylococcal Infections; Streptococcal Infections; Surgical Wound Infection; Tracheitis

To describe a new method for measuring facial swelling following orthognathic surgery using a 3D laser-scanning device.. Prospective clinical trial. Setting and Sample Population -- University Dental Hospital, Wales College of Medicine, Biology Life and Health Sciences. Three subjects requiring bi-maxillary orthognathic surgery were recruited for the study.. Laser-scanned images of the subjects were obtained under a reproducible and controlled environment with two Minolta Vivid 900 (Osaka, Japan) optical laser-scanning devices assembled as a stereo-pair. A set of left and right scanned images was taken for each subject and each scan took an average of 2.5 s. 3D laser scans were recorded over six time periods (T1 -- pre-surgical scan, postoperatively: T2 -- 1 day, T3 -- 1 week, T4 -- 1 month, T5 -- 3 months and T6 -- 6 months).. Facial scans from different time periods were overlaid onto the baseline (T6) facial scan to determine the reduction and changes in swelling following orthognathic surgery.. The results showed that swelling could be accurately quantified following surgery. Furthermore, there was a significant reduction in the amount of swelling 1 month postoperatively. Furthermore, the facial morphology returned to approximately 90% of the baseline facial scan at 3 months.. The 3D laser-scanning device and the method described was a reliable and accurate measure of facial swelling following surgery.

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents; Antibiotic Prophylaxis; Cephalometry; Dexamethasone; Edema; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Lasers; Male; Malocclusion, Angle Class III; Mandible; Maxilla; Postoperative Complications; Premedication; Prospective Studies

Experience of treatment of 43 patients, operated on for perforative gastroduodenal ulcer, was summarized. In 23 of them in the early postoperative period amoxyclav was applied for the treatment and prophylaxis, what have had assisted the reduction of the complications rate as well as the length of treatment of the patients in stationary. Good tolerance of the preparation was noted.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Humans; Male; Middle Aged; Peptic Ulcer; Peptic Ulcer Perforation; Peritonitis; Postoperative Complications; Sepsis; Suppuration; Treatment Outcome

To compare amoxicillin-clavulanic acid with cefazolin as ultra-short-term prophylaxis in laparotomic gynecologic surgery.. A prospective randomized study was conducted to compare two antimicrobial regimens in surgical prophylaxis of laparotomic surgery. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 min before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract, and respiratory tract.. In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 346 and 352 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both arms. Febrile morbidity occurred in 21 (6.1%) and 26 (7.4%) patients, respectively, in the amoxicillin-clavulanic acid and cefazolin groups. Wound infection and urinary tract infection were also higher, but not significantly in the cefazolin group (0.5% vs. 1.1% and 2.0% vs. 2.5%, respectively). There was one respiratory tract infection (0.2%) in Group B, and no septic death in either groups.. Ultra-short-term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe in elective laparotomic gynecologic surgery.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Cefazolin; Dose-Response Relationship, Drug; Drug Administration Schedule; Female; Follow-Up Studies; Genital Diseases, Female; Gynecologic Surgical Procedures; Humans; Laparotomy; Middle Aged; Postoperative Complications; Preoperative Care; Probability; Prospective Studies; Risk Assessment; Surgical Wound Infection; Treatment Outcome

Numerous studies have been published in recent years about antimicrobial prophylaxis in gynecologic surgery, but the optimal drug and schedule for the different surgical procedures is still a matter of debate. The aim of the present study was to compare two ultra-short term antimicrobial prophylaxis regimens (amoxicillin-clavulanic acid and cefazolin) in preventing infections following laparoscopic gynecologic operations. Three hundred sixty women hospitalized for a laparoscopic gynecologic surgery procedure were included in the study between January 1999, and December 2001. Patients were randomly allocated to receive amoxicillin-clavulanic acid (2.2 g) [Group A] or cefazolin (2 g) [Group B] as a single dose 30 minutes before surgery. Each patient was assessed daily until discharge to evidence febrile status and the presence of infections at the operative site, urinary tract and respiratory tract. In the amoxicillin-clavulanic acid (Group A) and cefazolin (Group B) groups, overall 164 and 172 patients, respectively, were evaluable for prophylactic efficacy at hospital discharge. Infectious complications were infrequent in both groups with febrile morbidity occurring in only one patient (0.6%) in the amoxicillin-clavulanic group. No sign of infections at the surgical site, urinary tract and respiratory tract was observed in either group. No death due to sepsis was recorded. It is concluded that ultra-short term prophylaxis with both amoxicillin-clavulanic acid and cefazolin is safe and effective in elective laparoscopic gynecologic surgery.

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Cefazolin; Drug Administration Schedule; Female; Follow-Up Studies; Genital Diseases, Female; Humans; Laparoscopy; Length of Stay; Middle Aged; Postoperative Complications; Preoperative Care; Probability; Prospective Studies; Reference Values; Risk Assessment; Treatment Outcome

Systemic antibiotics given during the first week after tonsillectomy appear to be effective in reducing postoperative morbidity. We assessed the effectiveness of perioperative topical antibiotic rinses in reducing posttonsillectomy morbidity.. A randomized, double-blinded, placebo-controlled pilot study of 36 patients undergoing tonsillectomy was used to evaluate the effects of a standard 7-day systemic regimen of perioperative intravenous ampicillin/oral amoxicillin and 2 single-day topical antibiotic regimens: (1) clindamycin (Cleocin) and (2) amoxicillin/clavulanate (Augmentin) and ticarcillin/clavulanate (Timentin).. Mean aerobic and anaerobic oral bacterial counts were decreased in both topical treatment groups compared with the placebo group on the first postoperative day, achieving statistical significance with Augmentin/Timentin (aerobic and anaerobic bacterial counts) and Cleocin (aerobic counts). Significantly less postoperative pain and mouth odor were reported for both Cleocin (P = 0.014 and P = 0.005, respectively) and Augmentin/Timentin (P = 0.026 and P = 0.05, respectively) topical treatment groups when compared with the placebo group.. Preliminary results indicate a reduction in oral bacterial counts and postoperative morbidity in adult patients receiving topical antibiotics compared with patients receiving placebo; further investigation is warranted.

Topics: Administration, Topical; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria; Clavulanic Acids; Clindamycin; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Female; Humans; Injections, Intravenous; Male; Mouth; Mouthwashes; Pilot Projects; Postoperative Complications; Surgical Wound Infection; Ticarcillin; Tonsillectomy

In a randomized trial of 440 patients undergoing elective colorectal surgery, the prophylactic efficacy and the safety of amoxycillin/clavulanic acid were compared with that of a control regimen of clindamycin and gentamicin. Surgical wound healing was assessed by the ASEPSIS points scale; it was normal in 86% of patients and the scores for both groups were not statistically different (amoxycillin/clavulanic acid: 11.1; clindamycin + gentamicin: 10.9). Intra-abdominal infections were more frequent in the clindamycin + gentamicin arm of the study (Fisher's exact test, P = 0.035). It is concluded that amoxycillin/clavulanic acid is as effective and safe as clindamycin + gentamicin in the prevention of wound infection and may provide better protection against intra-abdominal infections.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Clindamycin; Colonic Diseases; Cross Infection; Drug Therapy, Combination; Female; Gentamicins; Humans; Male; Middle Aged; Postoperative Complications; Prospective Studies; Rectal Diseases; Single-Blind Method; Wound Healing

Infections are still the most frequent postoperative complications and one of the limiting factors of successful gynaecological surgery. In recent years information on successful anti-microbial chemoprophylaxis is increasing and is associated with reduced postoperative inflammations, febrile morbidity and early complications. Views differ above all as regards indications for the use of antibiotic prophylaxis and the selection of a suitable antibiotic. Data in the literature differ also as regards achieved results. The submitted work had the objective to test on a representative group the success and rationality of medicamentous prophylaxis in gynaecological surgery and to contribute to a clearer view on controversial points. 203 women admitted to the Second Gynaecological and Obstetric Department of the First Medical Faculty Charles University and General Faculty Hospital Prague for elective abdominal or vaginal hysterectomy on account of a benign indication were divided into three groups which did not differ from the demographic or medical aspect. In group A (53 women) for prophylaxis two doses of Augmentin were used (combination of amoxycillin with clavulanic acid) i.v., patients in group M (50 women) had three doses of Mandol (Cefamandol) i.m., and in control group K (100 patients) no antibiotics were administered prophylactically. The authors investigated the postoperative course and evaluated some parameters in relation to possible postoperative infectious complications. The results proved unequivocally that prophylaxis with Augmentin reduces significantly the postoperative infectious morbidity (11.5%), febrile morbidity (5.6%) and the incidence of early infectious complications (3.8%) after abdominal or vaginal hysterectomy, as compared with the control group (35%, 31% and 11% resp.). Prophylaxis with Cefamandol reduced only in few parameters postoperative complications, but in general did not lead to a significant improvement of the postoperative course nor to a reduction of postoperative inflammatory complications. Similar results were obtained when only complications after abdominal hysterectomy were evaluated. The results of bacteriological examination confirmed the expected differences in the spectrum of efficacy of the two antibiotics on the most common microbial flora in the given area, i.e. a high sensitivity of Augmention to enterococci and bacterioids and resistance of these bacteria to Mandol. These results can be considered one of the re

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacterial Infections; Cefamandole; Cephalosporins; Drug Therapy, Combination; Female; Humans; Hysterectomy; Middle Aged; Postoperative Complications

A prospective, randomized, open study was performed in 199 patients at the Leyenburg Hospital comparing amoxycillin/clavulanate (AMX/CL) with cefuroxime plus metronidazole (CR/MN) in the prophylaxis of infection following gynaecological surgery. AMX/CL was given as a single dose of 2200 mg i.v. at the start of the operation. CR/MN, 750/500 mg i.v. was administered 3 times within 24 h, beginning at the start of the operation. The study group consisted of patients undergoing either a vaginal hysterectomy, a vaginal hysterectomy with cysto/rectocele repair or a secondary caesarean section. There were no statistically significant differences in demographic characteristics, duration of surgery or anaesthetic method between the two groups. Postoperatively, 10.6% of patients developed a urinary tract infection, and febrile temperatures were found in 9.0% of patients. There were no statistically significant differences between the two treatment groups. Other complications were found in less than 1% of the study population, equally distributed between the two regimens. In this study there was a low overall percentage of infection after gynaecological surgery. AMX/CL was as effective as CR/MN as a perioperative prophylactic treatment and has the dual advantage of a single dose and lower cost.

Topics: Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bacterial Infections; Cefuroxime; Cesarean Section; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Hysterectomy; Intraoperative Complications; Metronidazole; Middle Aged; Postoperative Complications; Pregnancy; Prospective Studies

A prospective, multicentre, randomized trial was carried out in 19 hospitals in order to compare the efficacy of amoxycillin-clavulanic acid with cefotetan as antibiotic prophylaxis in patients undergoing elective colorectal surgery. Since the main purpose of the study was to demonstrate equivalence between the two regimens, the protocol planned the inclusion of 200 patients. Eligible patients were randomly assigned to receive either amoxycillin-clavulanic acid (2.2 g) or cefotetan (2 g) in a single infusion on the induction of anaesthesia. Failure of prophylaxis was defined as occurrence of infection of intestinal origin, either minor (wound cellulitis) or major (abscess, peritonitis, septicaemia) within the 30-day postoperative period. Among 221 randomized patients, 208 (105 amoxycillin-clavulanic acid, 103 cefotetan) aged 66 +/- 12 years (mean +/- SD) were evaluated while 13 were withdrawn. Colorectal cancer was the indication for surgery in 73% of cases. Eleven (10 +/- 6%, 95% confidence interval) and 13 (13 +/- 7%) failures were observed in the amoxycillin-clavulanic acid and cefotetan groups (P = 0.63 chi-square test) respectively. Most infections occurred before the 10th postoperative day (8% failures at this time, estimated by the Kaplan-Meier method). The results of the trial demonstrate that amoxycillin-clavulanic acid and cefotetan have similar efficacy when used for prophylaxis of infection after elective colorectal surgery.

Topics: Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bacterial Infections; Cefotetan; Clavulanic Acids; Colon; Colorectal Neoplasms; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Postoperative Complications; Premedication; Prospective Studies; Rectum; Surgical Wound Infection; Treatment Outcome; Urinary Tract Infections

One hundred and one adult patients undergoing tonsillectomy for chronic/recurrent tonsillitis completed a prospective, randomized, double-blind, placebo-controlled study in which ticarcillin disodium and clavulanate potassium (Timentin) or placebo was administered intravenously at the time of surgery and for 12 hours postoperatively. The patients than received oral amoxicillin and clavulanate potassium (Augmentin) therapy or placebo for an additional seven days. Each patient kept a daily log to assess the incidence and severity of postoperative symptoms. Tonsillar core tissue at the time of surgery, as well as tonsillar fossa cultures after 7 days of treatment, were obtained. Those patients who received antibiotics fared consistently better in the immediate postoperative period compared with the placebo group. Specifically, patients in the antibiotic group experienced significantly less mouth odor, were able to tolerate a regular diet sooner, and resumed their normal activities earlier than did patients who received placebo. Patients who received antibiotics experienced fewer days with mouth odor (p = 0.004). In addition, on postoperative days 3 to 5, the antibiotic group was eating a regular diet (p = 0.05) and had returned to their routine activities earlier (p = 0.045) when compared with the placebo group. Perioperative antibiotic therapy was well tolerated and was effective in minimizing symptoms after tonsillectomy.

Topics: Adolescent; Adult; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Child; Clavulanic Acids; Double-Blind Method; Drug Therapy, Combination; Female; Halitosis; Humans; Male; Postoperative Complications; Postoperative Period; Premedication; Prospective Studies; Ticarcillin; Tonsillectomy

This paper reports the results of a pilot study which examined factors associated with chest infection following head and neck surgery. The overall rate of chest infection was 11%, but was 20% in those patients having a tracheotomy. No infection developed in patients with an intact airway. Other factors which emerged as possibly important were the duration of surgery and heavy regular alcohol intake. We recommend that prophylactic antibiotics be continued for at least 48 h in patients requiring a tracheotomy as part of their head and neck surgery. This is against the trend of shorter antibiotic regimens recommended for prevention of wound infections.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Clavulanic Acids; Drug Therapy, Combination; Floxacillin; Humans; Metronidazole; Middle Aged; Otorhinolaryngologic Diseases; Pilot Projects; Postoperative Complications; Premedication; Respiratory Tract Infections

A randomized controlled trial was designed to compare antibiotic prophylaxis with a standard combination of agents, metronidazole and gentamicin, with a single preparation, amoxycillin/clavulanate in 400 patients undergoing elective colorectal surgery. There were 41 patients who were excluded or withdrawn (wrong dose, inappropriate operation, established sepsis or concurrent disease). Abdominal wound sepsis occurred in 14% of the assessable patients in the amoxycillin/clavulanate group and in 15% of the metronidazole plus gentamicin group. Perineal sepsis occurred in 27% of the amoxycillin/clavulanate group with a perineal wound compared with 18% in the metronidazole plus gentamicin group. Intra-abdominal abscess occurred in 8% of those who received amoxycillin/clavulanate compared with 6% of those given metronidazole plus gentamicin. Only two patients in each group developed septicaemia. Postoperative diarrhoea occurred in 11 patients receiving amoxycillin/clavulanate compared with four given metronidazole plus gentamicin. Clostridium difficile was not isolated from the stool cultures in any of these cases. Thirteen of the 164 abdominal or perineal wounds were infected by 15 strains of Bacteroides spp. in the group receiving amoxycillin/clavulanate compared with only three of the 165 wounds in those given metronidazole plus gentamicin. (P less than 0.01). There was no other significant difference in the pattern of isolates between the groups.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Colon; Drug Therapy, Combination; Female; Gentamicins; Humans; Male; Metronidazole; Middle Aged; Postoperative Complications; Randomized Controlled Trials as Topic; Rectum; Surgical Wound Infection

A randomized comparative study was conducted to evaluate the clinical efficacy of amoxycillin/clavulanate (Augmentin) compared with mezlocillin for the prevention of wound infection in patients undergoing abdominal surgery. There was no difference in overall wound infection rates between the amoxycillin/clavulanate treated group and the mezlocillin group. When sub-groups were examined for total infections no significant difference was seen between antibiotic groups in patients undergoing clean/potentially contaminated operations or contaminated operations, although more deep infections were encountered in the amoxycillin/clavulanate group in comparison with the mezlocillin group, in contaminated operations. The type of operation performed also failed to show any difference in those patients undergoing upper gastro-intestinal, appendiceal, colonic, or biliary operations. The infections in those receiving amoxycillin/clavulanate were largely of bowel origin and predominantly sensitive to amoxycillin/clavulanate. Those in the mezlocillin group were predominantly staphylococcal in origin. Amoxycillin/clavulanate appears to be an effective antibiotic for use as a single agent in surgical prophylaxis.

Topics: Abdomen; Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Mezlocillin; Middle Aged; Postoperative Complications; Randomized Controlled Trials as Topic; Surgical Wound Infection

A small prospective trial was conducted to evaluate the effectiveness and safety of a single antibiotic regimen, Augmentin, compared with a combination regimen of cefuroxime and metronidazole in the treatment of serious post-operative sepsis. Both regimens used were effective against Bacteroides and other anaerobes, with a similar satisfactory cure rate and no serious side effects. Intravenous Augmentin was easy to use and the change to oral therapy was significantly quicker than in the cefuroxime-metronidazole treatment arm. No significant resistance or serious adverse reaction was noted. The majority of patients had more than one site of infection, making selective antibiotic treatment difficult.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Bacterial Infections; Cefuroxime; Cephalosporins; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Male; Metronidazole; Middle Aged; Postoperative Complications; Prospective Studies; Randomized Controlled Trials as Topic

Acute appendicitis is the most frequent surgical emergency in the paediatric population. Complicated appendicitis accounts for 30% of cases and is inextricably linked to postoperative infectious complications. A study at our institution showed that amoxicillin-clavulanate resistant Escherichia coli in complicated appendicitis was significantly linked to postoperative infectious complications. These findings led to a change in the empirical antibiotic protocol (amoxicillin-clavulanate changed to ceftriaxone + metronidazole as of 2017), intending to reduce postoperative infectious complications in complicated appendicitis in our institution.. This study aimed to analyse the microbiology and resistance profiles of pathogens of complicated appendicitis at our institution since implementing the new antibiotic protocol and the postoperative infectious complications rate.. We designed a retrospective comparative cohort study. During the defined study period (01 January 2017 to 31 July 2020), medical records were analysed for cases of acute appendicitis, complicated appendicitis and postoperative infectious complications, retaining only those who fulfilled inclusion criteria. Postoperative outcomes, microbiology and antibiotic resistance of peritoneal swabs were analysed.. During the study period, 95 patients presented with a complicated appendicitis, and 11 (12%) developed postoperative infectious complications. The most frequent pathogens found in complicated appendicitis were E. coli (66%), Streptococcus anginosus (45%), and Bacteroides fragilis (22%). Pseudomonas aeruginosa was present in 17% of complicated appendicitis. Pathogens involved in postoperative infectious complications mirrored the distribution found in complicated appendicitis without postoperative infectious complications. Antibiotic susceptibility analysis showed that 10 (15%) of E. coli strains were resistant to amoxicillin-clavulanate but sensitive to ceftriaxone + metronidazole, with only one strain responsible for causing a postoperative infectious complication. Six additional strains of E. coli (9%) were resistant to amoxicillin-clavulanate and our empirical antibiotic regimen but were not associated with an increase in postoperative infectious complications. Compared with our previous study, there was a decrease in postoperative infectious complications from 16% to 12%. Postoperative infectious complications caused by amoxicillin-clavulanate-resistant E. coli decreased from 28% to 9%.. This retrospective study demonstrated a decrease in the rate of postoperative infectious complications due to amoxicillin-clavulanate-resistant E. coli in complicated appendicitis. These findings accentuate the need to implement evidence-based treatment protocols based on local microbiology profiles and resistance rates to optimise post-operative antibiotics in complicated appendicitis.

Topics: Acute Disease; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Appendectomy; Appendicitis; Ceftriaxone; Child; Clinical Protocols; Cohort Studies; Escherichia coli; Humans; Metronidazole; Postoperative Complications; Retrospective Studies

Postpartum endometritis accounts for 2% of postpartum infections in developed countries. In France, 2.3% of deaths are attributed to puerperal infections. The most important risk factor is cesarean delivery, especially if it is done after the start of labor. Bacteria of the vaginal microbiota are associated with postpartum endometritis. Symptoms are abdomino-pelvic pain, hyperthermia and abnormal lochia. The diagnosis is confirmed by uterine mobilization pain. The first-line antibiotic therapy is amoxicillin-clavulanic acid 3 to 6 grams per day depending on the weight, intravenously or orally. In case of impossibility to use penicillins (anaphylaxis for example), the combination of clindamycin 600mg×4/d plus gentamicin 5mg/kg×1/d may be use, it must be a specialized decision in case of maternal breastfeeding. The treatment is continued until obtaining 48hours of apyrexia and the disappearance of pelvic pain. In case of persistence of fever and/or pelvic pain after 72hours of antibiotic therapy, pelvic imaging should be performed for placental retention, septic thrombophlebitis, deep abscess or any other surgical complication and eliminate differential diagnoses. It is important to highlight the difficulties of interpreting endo-uterine images in ultrasound. Hypocoagulant heparin therapy should be started in case of septic thrombophlebitis for 6 weeks, or longer if there are complications such as embolism or thrombotic risk factors. Regarding prevention, during a caesarean section, a vaginal swab with iodinated polividone or chlorhexidine is recommended before caesarean if possible, and extraction of the placenta must be spontaneous.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anticoagulants; Cesarean Section; Endometritis; Female; Fever; Humans; Pelvic Inflammatory Disease; Pelvic Pain; Postoperative Complications; Pregnancy; Puerperal Infection; Risk Factors; Thrombophlebitis; Vagina

Topics: Acute Generalized Exanthematous Pustulosis; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Biopsy; Humans; Intubation, Intratracheal; Laryngeal Edema; Laryngoscopy; Male; Nasal Polyps; Postoperative Complications; Prednisolone; Pulse Therapy, Drug; Skin; Treatment Outcome

Erysipelothrix rhusiopathiae is a widespread Gram-positive, nonsporulating rod bacterium predominantly associated with skin disease in swine and cetaceans. Cutaneous lesions have yet to be described in dogs.. To describe the clinical presentation, molecular and histopathological diagnosis, and treatment of a case of erysipeloid caused by E. rhusiopathiae in a dog.. A 6-month-old spayed female standard poodle dog presented with lethargy, fever, vomiting and diarrhoea. Skin lesions appeared 20 days post first examination.. Complete blood count, serum chemistry profile, urinalysis, urine culture, blood culture, computed topography, forelimb radiography, joint and cerebrospinal fluid aspiration were performed; samples were collected for skin cytological evaluation, culture and histopathological analysis.. Blood cultures yielded Gram-positive, catalase-negative bacilli. Histopathological evaluation of skin biopsies revealed lymphoplasmacytic, neutrophilic and histiocytic perivascular and periadnexal dermatitis, and vasculitis. Cutaneous and blood PCR and sequencing of 16S rRNA identified the bacteria as E. rhusiopathiae. Clinical resolution was observed following the use of of amoxicillin/clavulanic acid and ciprofloxacin therapies.. To the best of the authors' knowledge, this is the first confirmed case of erysipeloid caused by E. rhusiopathiae in a dog. Clinical resolution was attained with the extended use of antibiotics. After 13 months, no clinical signs had returned.. Erysipelothrix rhusiopathiae est une bactérie en bâtonnet, Gram positive, non sporulante, répandue, principalement associée à des dermatoses chez le porc et les cétacées. Les lésions cutanées doivent encore être décrites chez le chien.. Décrire la présentation clinique, le diagnostic histopathologique et moléculaire et le traitement d'un cas du à E. rhusiopathiae chez un chien.. Un caniche standard femelle stérilisée de 6 mois présenté pour abattement, fièvre, vomissement et diarrhée. Les lésions cutanées sont apparues 20 jours après le premier examen. MATÉRIELS ET MÉTHODES: Une numération formule, un profil biochimique, une analyse urinaire, une culture urinaire, une culture sanguine, un examen tomodensitométrique, une radiographie des membres antérieurs, une aspiration du liquide articulaire et cérébrospinal ont été réalisés; les échantillons ont été prélevés pour cytologie cutanée, culture et analyse histopathologique. RÉSULTATS: Les cultures sanguines ont permis la croissance de bacilles catalase négatives, Gram-positives. L’évaluation histopathologique des biopsies cutanées a révélé une vascularite et dermatite périvasculaire et périanexielle histiocytaire et neutrophilique, lymphocytoplasmique. Les PCR sanguine et cutanée et le séquençage d’ARNr 16S ont identifiés la bactérie E. rhusiopathiae. La résolution clinque a suivi l'utilisation d'amoxicilline acide clavulanique et de ciprofloxacine.. A la connaissance des auteurs, ceci est le premier à confirmer un cas érysipeloïde due à E. rhusiopathiae chez un chien. La résolution clinique a été obtenue avec l'utilisation prolongée d'antibiotiques. Après 13 mois, aucun signe clinique n'a récidivé.. INTRODUCCIÓN: Erysipelothrix rhusiopathiae es un bacilo Gram-positivo, no esporulante, predominantemente asociado con enfermedades de la piel en cerdos y cetáceos. Las lesiones cutáneas aún no se han descrito en perros. OBJETIVO: describir la presentación clínica, el diagnóstico molecular e histopatológico y el tratamiento de un caso de erisipeloide causado por E. rhusiopathiae en un perro. ANIMALES: una perra caniche esterilizada de 6 meses que se presentó con letargia, fiebre, vómitos y diarrea. Las lesiones cutáneas aparecieron 20 días después del primer examen. MÉTODOS Y MATERIALES: se realizó hemograma completo, perfil serológico bioquímica, análisis de orina, cultivo de orina, hemocultivo, tomografía computerizada, radiografía de extremidad anterior, aspiración de líquido cefalorraquídeo y de articulaciones; se recolectaron muestras de piel para la evaluación citológica, cultivo y análisis histopatológico. RESULTADOS: los hemocultivos produjeron bacilos Gram positivos y catalasa negativos. La evaluación histopatológica de las biopsias de piel reveló dermatitis perivascular y periadnexal linfoplasmocítica, neutrofílica e histiocítica y vasculitis. La PCR cutánea y sanguínea y la secuenciación de 16S rRNA identificaron las bacterias como E. rhusiopathiae. Se consiguió la resolución clínica mediante el uso de amoxicilina/ácido clavulánico y ciprofloxacina. CONCLUSIONES E IMPORTANCIA CLÍNICA: a entender de los autores, este es el primer caso confirmado de erisipeloide causado por E. rhusiopathiae en un perro. La resolución clínica se logró con el uso prolongado de antibióticos. Después de 13 meses, no habían vuelto a verse los signos clínicos.. Erysipelothrix rhusiopathiae ist ein weitverbreitetes Gram-positives, nicht-sporulierendes Stäbchenbakterium, welches hauptsächlich bei Hauterkrankungen beim Schwein und Walen eine Rolle spielt. Hautveränderungen müssen bei Hunden noch beschrieben werden. ZIEL: Eine Beschreibung der klinischen Präsentation, der molekularen und histopathologischen Diagnose und der Behandlung eines Falls von Erysipeloid, verursacht durch E. rhusiopathiae bei einem Hund.. Eine 6 Monate alte kastrierte Standardpudelhündin wurde mit Lethargie, Fieber, Vomitus und Diarrhoe vorgestellt. Hautveränderungen traten 20 Tagen nach der ersten Untersuchung auf.. Ein komplettes Blutbild, Serumbiochemie, Urinanalyse, Harnkultur, Blutkultur, Computertomografie, Röntgenuntersuchung der Vorderextremität, Aspiration von Gelenks- und Cerebrospinalflüssigkeit wurden durchgeführt; es wurden Proben für eine zytologische Untersuchung der Haut genommen, sowie eine Kultur und eine histopathologische Analyse durchgeführt.. Die Blutkulturen ergaben Gram-positive, Katalase-negative Bazillen. Die histopathologische Evaluierung der Hautbiopsien zeigte lymphoplasmazelluläre, neutrophile und histiozytäre perivaskuläre und periadnexale Dermatitis und Vaskulitis. Haut und Blut PCR und eine Sequenzierung der 16S rRNA identifizierten die Bakterien als E. rhusiopathiae. Eine klinische Heilung erfolgte nach Anwendung von Amoxicillin/Clavulansäure und einer Ciprofloxacin Therapie.. Nach bestem Wissen der Autoren handelt es sich hierbei um den ersten bestätigten Fall eines Erysipeloids, verursacht durch E. rhusiopathiae bei einem Hund. Durch den verlängerten Einsatz der Antibiotika war die klinische Heilung dauerhaft. Nach 13 Monaten war es nicht zum Wiederauftreten klinischer Anzeichen gekommen.. 背景: Erysipelothrix rhusiopathiaeは、主に豚および鯨目動物の皮膚疾患に関連する一般的に普及したグラム陽性非芽胞性桿菌である。皮膚の顕微鏡的病変は犬においていまだ説明されていない。 目的: 本研究の目的は、1頭の犬のE. rhusiopathiaeによる類丹毒症例の臨床像、分子病理学的および病理組織学的診断、ならびに治療について説明することである。 被験動物: 6か月齢、避妊雌のスタンダード・プードルが嗜眠、発熱、嘔吐および下痢を呈した。最初の診察時から20日後に皮膚病変が出現した。 材料と方法: 全血球計算、血清化学プロファイル、尿検査、尿培養、血液培養、コンピュータートポグラフィー、前肢のレントゲン撮影、関節および脳脊髄液吸引を実施した。サンプルを皮膚細胞学的評価、培養および組織病理学的解析のために集積した。 結果: 血液培養によりグラム陽性カタラーゼ陰性桿菌が検出された。皮膚生検による組織病理学的評価により、リンパ球形質細胞性、好中球性および組織球性の血管および付属器周囲炎、ならびに血管炎が明らかにされた。皮膚および血液PCRならびに16S rRNA配列決定により、細菌をE. rhusiopathiaeと同定した。アモキシシリン/クラブラン酸およびシプロフロキサシン療法の使用により臨床的に解決した。 結論と臨床的重要性: 著者の知る限りでは、本症例は犬においてE. rhusiopathiaeによる類丹毒の発症を確認した初めての症例である。抗生物質を長期間使用することで臨床的解決を達成した。 13ヵ月後、臨床的徴候は再燃していなかった。.. 背景: 猪丹毒杆菌(Erysipelothrix rhusiopathiae)是一种广谱、革兰氏阳性、无孢囊杆状细菌,可引起猪和鲸类的皮肤病,但皮肤显微镜下的病变尚未在犬中描述。 目的: 报告猪丹毒杆菌引起的一例犬皮肤类丹毒的临床表现、分子和组织病理学诊断及治疗。 动物: 一只6月龄的雌性标准贵宾犬,出现嗜睡、发烧、呕吐和腹泻等症状。首次检查后20天出现皮肤病变。 方法和材料: 进行全血细胞计数、血清化学谱,尿液分析、尿液培养、血液培养、CT、前列腺造、关节和脑脊液抽吸等检查; 采集样本用于皮肤细胞学评估、培养和组织病理学分析。 结果: 血液培养产生革兰氏阳性、过氧化氢酶阴性杆菌。皮肤活检的组织病理学评估显示淋巴浆细胞性、中性粒细胞性和组织细胞性血管周皮炎、附件周皮炎和血管炎。皮肤和血液PCR,以及16S rRNA的测序将细菌鉴定为猪丹毒杆菌。临床使用阿莫西林/克拉维酸和环丙沙星治疗后症状消退。 结论和临床意义: 据作者所知,这是第一个确诊由猪丹毒杆菌引起犬的类丹毒病例。随着使用全身性抗生素,临床症状得以解决。13个月后,临床症状没有复发。.. Erysipelothrix rhusiopathiae é uma bactéria bem disseminada, Gram-positiva, não formadora de esporos predominantemente associada a doença de pele em suínos e cetáceos. Lesões cutâneas não foram ainda descritas em cães.. Descrever a apresentação clínica, diagnóstico molecular e histopatológico e tratamento de um caso de erisipela causada por E. rhusiopathiae em um cão.. Uma cadela poodle castrada de seis meses de idade foi apresentada com letargia, febre, vômito e diarreia. As lesões cutâneas apareceram 20 dias após a primeira consulta. MÉTODOS E MATERIAIS: Foram realizados hemograma, perfil bioquímico, urinálise, urocultura, hemocultura, tomografia computadorizada, radiografia de membros torácicos e punção de líquido cefalorraquidiano e sinovial; coletou-se amostras para citologia de pele, cultura e exame histopatológico.. Houve crescimento de bacilos Gram-positivos, catalase-negativos na hemocultura. A avaliação histopatológica das biópsias cutâneas revelou vasculite e dermatite perivascular e perianexial linfoplasmocítica, neutrofílica e histiocítica. A PCR de pele e sangue e o sequenciamento do 16S rRNA identificou a bactéria como E. rhusiopathiae. Ocorreu resolução clínica com o uso de amoxicilina/ácido clavulânico e ciprofloxacino. CONCLUSÕES E IMPORTÂNCIA CLÍNICA: De acordo com os conhecimentos do autor, este é o primeiro relato de caso confirmado de erisipela causada por E. rhusiopathiae em um cão. A resolução clínica foi alcançada com uso extenso de antibióticos. Após 13 meses, não houve recidiva de sinais clínicos.

Topics: Amoxicillin-Potassium Clavulanate Combination; Animals; Anti-Bacterial Agents; Ciprofloxacin; Dog Diseases; Dogs; Erysipeloid; Erysipelothrix; Female; Postoperative Complications

Topics: Adenocarcinoma; Amoxicillin-Potassium Clavulanate Combination; Bacteria, Anaerobic; Ceftriaxone; Combined Modality Therapy; Drainage; Drug Resistance, Microbial; Fever; Firmicutes; Gram-Positive Bacterial Infections; Gram-Positive Cocci; Humans; Lymph Node Excision; Lymphocele; Male; Middle Aged; Postoperative Complications; Prostatectomy; Prostatic Neoplasms

Biphosphonate-related osteonecrosis of the jaw (BRONJ) is a potential side effect associated with the administration of bisphosphonates; the aim of this work is to highlight the possible epidemiological differences between two groups of patients affected by medication related osteonecrosis of the jaw (MRONJ) treated at the Center of Oral Medicine, Pathology and Laser Surgery of the Academic Hospital at the University of Parma, Italy, between January 2004 and June 2016.. Medical charts of 303 patients (214 females and 89 males, mean age: 67 years old) treated at the Center of Oral Medicine, Pathology and Laser Surgery of the Academic Hospital at the University of Parma, between January 2004 and June 2016, were retrospectively analyzed. Patients were divided in 2 groups according to drugs therapy they underwent: group 1 (G1) including patients treated with bisphosphonates alone and group 2 (G2) including patients receiving antiresorptive-antiangiogenic drugs in association with bisphosphonates or antiresorptive-antiangiogenic drugs alone. Than 269 MRONJ sites treated with 5 different therapeutical approaches were analyzed.. Results showed G1 consisting mainly in female patients undergoing bisphosphonates for oncologic disease, stage II was most frequently diagnosed and MRONJ developed mainly after dental extraction or bone surgery. G2 consisted mainly in males patients, whom took antiresorptive-antiangiogenic drugs in association with bisphosphonate or antiresorptive-antiangiogenic drugs alone for oncologic disease. Stage II was most frequently diagnosed and MRONJ developed most frequently "spontaneous".. This study showed how a new population affected by MRONJ is emerging. Men affected by kidney cancer treated with new antiresorptive-antiangiogenic drugs will represent a growing portion of the pool of patients at risk. In our experience, a strict follow-up is of outmost importance to early detect MRONJ also in patients with spontaneous cases. When MRONJ occurs, surgical laser treatment with Er:YAG seems to represent the option with highest percentage of success; for patients with contraindication to surgery, LLLT helps to improve outcomes of the medical therapy.

Topics: Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Angiogenesis Inhibitors; Antibodies, Monoclonal; Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Bone Neoplasms; Combined Modality Therapy; Dental Implants; Diphosphonates; Drug Therapy, Combination; Female; Humans; Laser Therapy; Lasers, Solid-State; Male; Metronidazole; Middle Aged; Osteoporosis; Postoperative Complications; Retrospective Studies; Risk; Risk Factors; Tooth Extraction

Topics: Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Androstanols; Anemia; Anesthesia; Anesthetics, Inhalation; Antibiotic Prophylaxis; Blood Transfusion; Carcinoma, Basal Cell; Carcinoma, Squamous Cell; Child; Child, Preschool; Dermatologic Surgical Procedures; Female; Humans; Laryngeal Masks; Male; Methyl Ethers; Monitoring, Intraoperative; Neuromuscular Nondepolarizing Agents; Postoperative Complications; Prospective Studies; Rocuronium; Sevoflurane; Skin Neoplasms; Xeroderma Pigmentosum; Young Adult

To date, there have only been 5 reported cases of orbital cellulitis following implantation of an aqueous tube shunt for glaucoma. Previously reported cases have involved eyes with significant comorbidities and successful management has often required the removal of the device alongside systemic antibiotic therapy.. We present a 53-year-old man with severe orbital cellulitis, 3 months after routine implantation of a Baerveldt tube shunt for primary open angle glaucoma. The patient was managed medically, with topical and systemic antibiotic therapy. The patient went on to make a full recovery with the tube in situ.. We report that a more conservative approach (without tube removal) to be successful in a case where there is no evidence of tube exposure. It is important to appreciate that in some cases of orbital cellulitis without clear signs of intraocular involvement, a tube can be left in situ.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Therapy, Combination; Floxacillin; Glaucoma Drainage Implants; Glaucoma, Open-Angle; Humans; Intraocular Pressure; Levofloxacin; Male; Middle Aged; Orbital Cellulitis; Postoperative Complications; Retrospective Studies; Tomography, X-Ray Computed

Topics: Actinomycetales Infections; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Drug Resistance, Multiple, Bacterial; Drug Substitution; Female; Humans; Immunocompromised Host; Kidney Transplantation; Micrococcaceae; Postoperative Complications; Pyelonephritis; Self Care; Urinary Catheterization; Young Adult

Perimandibular abscesses require drainage and removal of the underlying cause of infection. Traditionally drainage was established extraorally, but this can be associated with delay to treatment, because this is done under general anaesthesia. Between July 2008 and June 2013, 205 patients were initially either treated by immediate intraoral incision under local anaesthesia or extraoral incisions under general anaesthesia and prospectively evaluated. Predictors of treatment outcomes and complications were analysed. Fewer secondary procedures were needed for patients with primary treatment under general anaesthesia (p < 0.0001), but the overall stay in hospital was shorter after initial treatment under local anaesthesia (p < 0.0001, Odds Ratio (OR) 0.72, 95% CI 0.62-0.85). Postoperative complications occurred significantly more often under general anaesthesia (p < 0.0001, OR = 16.63, 95% CI 5.59-49.5). Significant prognostic variable was the administration of amoxicillin combined with clavulanic acid (p = 0.016, OR = 1.24, 95% CI 1.09-1.41) and adverse prognostic factors were infections with Human Immunodeficiency Virus (HIV) (p = 0.048, OR 17.45, 95% CI 1.02-298) or diabetes mellitus (p = 0.003, OR 10.39, 95% CI 2.23-48.41). Amoxicillin combined with clavulanic acid showed a significant impact on the treatment course of patients with perimandibular abscesses.

Topics: Abscess; Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anesthesia, General; Anti-Bacterial Agents; beta-Lactamase Inhibitors; Child; Diabetes Complications; Drainage; Female; HIV Infections; Humans; Length of Stay; Male; Mandibular Diseases; Middle Aged; Nerve Block; Postoperative Complications; Prospective Studies; Reoperation; Treatment Outcome; Young Adult

Topics: Actinomyces; Actinomycosis; Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cholecystectomy, Laparoscopic; Coinfection; Cutaneous Fistula; Escherichia coli; Escherichia coli Infections; Humans; Male; Penicillins; Pleural Effusion; Postoperative Complications; Respiratory Tract Fistula; Thoracic Wall; Tomography, X-Ray Computed

Pasteurella multocida a small gram-negative coccobacilli is primarily found as normal flora of cats and dogs. These organisms can cause a variety of infections in humans, usually the result of scratches, bites and licks by percutaneous inoculation of the organism. Most cases of septic arthritis involve a cat or dog bite distal to the involved joint without direct penetrating injury to the joint. On scenarios were Pasteurella infection is suspected within a prosthetic joint, aggressive surgical debridement and/or removal of the prosthesis with intravenous antibiotics is recommended. Prosthetic joint infections secondary to animal bites are an extremely rare complication and few cases have been reported in the literature. This is a case report of a patient that suffered a cat's bite of his right prosthetic knee and against all odd was able to save it without surgical intervention.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Ampicillin; Animals; Anti-Bacterial Agents; Arthritis, Infectious; Arthroplasty, Replacement, Knee; Bites and Stings; Cats; Combined Modality Therapy; Debridement; Humans; Male; Mouth; Osteoarthritis, Knee; Pasteurella Infections; Pasteurella multocida; Postoperative Complications; Prosthesis-Related Infections; Sulbactam; Surgical Wound Infection; Wound Infection

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Cholangiography; Cholecystectomy; Cholecystectomy, Laparoscopic; Cholecystitis, Acute; Choledocholithiasis; Endoscopy, Gastrointestinal; Female; Humans; Male; Postoperative Complications

Topics: Administration, Oral; Administration, Topical; Adrenal Cortex Hormones; Amoxicillin-Potassium Clavulanate Combination; Bacitracin; Bacterial Infections; Child, Preschool; Colistin; Germany; Humans; Hydrocortisone; Middle Ear Ventilation; Otitis Media, Suppurative; Postoperative Complications; Randomized Controlled Trials as Topic

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Bacterial Infections; Cholecystectomy; Cholecystitis, Acute; Female; Humans; Male; Postoperative Complications

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chest Pain; Female; Gastroesophageal Reflux; Gastroplasty; Humans; Laparoscopy; Obesity, Morbid; Pneumonia, Aspiration; Pneumonia, Bacterial; Postoperative Complications; Radiography

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Arteritis; Bronchopneumonia; Ductus Arteriosus, Patent; Endocarditis, Bacterial; Equipment Failure; Female; Fever; Humans; Postoperative Complications; Prosthesis-Related Infections; Pulmonary Artery; Septal Occluder Device; Streptococcal Infections; Tomography, X-Ray Computed; Ultrasonography; Young Adult

The incidence of infection following TEVAR is low. To the best of our knowledge, this is the first case report of post thoracic endovascular aortic repair (TEVAR) with Streptococcus viridans graft infection. A 54-year-old male underwent TEVAR for dissecting thoracic aneurysm with spinal ischaemia. He had an eventful recovery with prolonged period of stay in intensive care unit. Three months later, he presented with persistent chest discomfort and fever. Computed tomography (CT) of the thorax revealed evidence of graft infection and the blood culture grew Streptococcus viridans. The rarity of TEVAR graft infection due to Streptococcus viridans and its management are being discussed.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Aortic Aneurysm, Thoracic; Aortic Dissection; Bacteremia; Blood Vessel Prosthesis Implantation; Endovascular Procedures; Esophageal Fistula; Fever; Humans; Ischemia; Male; Middle Aged; Myocardial Infarction; Paraplegia; Penicillins; Postoperative Complications; Prosthesis-Related Infections; Radiography; Spinal Cord; Streptococcal Infections; Vascular Fistula; Viridans Streptococci

Orbital fractures represent 30 % of children facial fractures. Nausea and vomiting are more predictive of entrapment than local trauma stigmatisms. Entrapment and diplopia are more frequent in adults. Delay for surgery is unclear in literature varying from 6 hours to days. The aim of this study is to summarise the aspects of orbital floor fractures in children with regard to clinical and radiological presentation, management, and outcomes.. We conducted a retrospective study including 34 children presenting isolated orbital floor fracture. Clinical, radiological, ophthalmological, surgical data and outcomes were analyzed.. Mean age was 9.4 years. In 15% of cases, no local stigmatism of trauma was present. Entrapment fracture was the most frequent, with 81% of fat or muscles entrapment. In all, 27% of the patient had residual diplopia. Residual diplopia developed after trap-door fracture with muscle entrapment and a more than 24 hours delay for surgery.. Trap-door fracture is frequent in childhood population. Clinical diagnosis can be difficult. However, surgical treatment should be considered before 24 hours to avoid complication as residual diplopia.

Topics: Adolescent; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Anti-Inflammatory Agents; Child; Child, Preschool; Diplopia; Female; Humans; Infant; Male; Methylprednisolone; Ophthalmoplegia; Orbital Fractures; Postoperative Complications; Preoperative Care; Retrospective Studies; Tomography, X-Ray Computed

Chronic pilonidal disease is a debilitating condition that typically affects young adults. There is a wide variety of available therapeutic strategies reflecting the inconsistent outcomes attributed to the various operative approaches. The majority involve excision of the sinus tract followed by either primary closure or healing by secondary intention. A variety of closure approaches exist. There remains uncertainty as to which is more effective. The aim of the current study was to determine subjective and objective outcomes following excision and Karydakis flap closure in a unit where this technique is the standard of care in the management of chronic pilonidal disease.. This study involving consecutive patients with chronic pilonidal disease was conducted over a 4-year period. A tailored patient satisfaction questionnaire was given to each patient. Postoperative primary and secondary outcomes were evaluated. The mean follow-up time was 30 months.. One hundred six consecutive patients (33 female, 73 male) underwent excision and primary closure using the Karydakis flap. Ninety-two completed questionnaires were returned (87% response rate). Patients consulted their general practitioner 2.8 times (mean) and 46% received empirical oral antimicrobial therapy prior to referral for a surgical opinion. The mean time lost to work/school following the Karydakis flap repair was 13 days (range 3-33). Successful treatment was achieved in 96.3% of cases and 92% of patients were satisfied with their operative result.. Excision and primary closure with Karydakis flap is an effective treatment for chronic pilonidal disease. It is associated with low morbidity, early return to premorbid functioning, and a high degree of patient satisfaction (92%).

Topics: Abscess; Adolescent; Adult; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Female; Germany; Humans; Male; Middle Aged; Pain, Postoperative; Patient Satisfaction; Pilonidal Sinus; Postoperative Complications; Surgical Flaps; Surveys and Questionnaires; Suture Techniques; Young Adult

Acquired long QT syndrome is a rare condition whose diagnosis is of vital importance given the risk of torsade de pointes and sudden death. This syndrome may be triggered by various events in patients with a genetic predisposition. Patients usually have a normal baseline QT interval. Some of the factors that may prolong the interval are exposure to common drugs such as antibiotics or agents used for general anesthesia. Diagnosis of the condition is essential, as is knowledge of how to manage anesthesia and prevent ventricular fibrillation, which is the most feared complication. We report the case of a man with no relevant medical history who underwent emergency surgery for a peritonsillar abscess. The patient developed long QT syndrome, with several episodes of torsade de pointes and cardiorespiratory arrest.

Topics: Adjuvants, Anesthesia; Adrenergic beta-Antagonists; Amoxicillin-Potassium Clavulanate Combination; Anesthetics, Inhalation; Anti-Bacterial Agents; Anti-Infective Agents; Combined Modality Therapy; Drainage; Electric Countershock; Heart Arrest; Humans; Long QT Syndrome; Male; Methyl Ethers; Metronidazole; Middle Aged; Peritonsillar Abscess; Postoperative Complications; Quaternary Ammonium Compounds; Sevoflurane; Torsades de Pointes; Ventricular Fibrillation

Tonsillectomy is the most common surgery performed in the pediatric and young adult populations. Although recent guidelines based on meta-analysis suggest that perioperative chemoprophylaxis plays a role in reducing bacteraemia-related post-tonsillectomy complications, there is no evidence or agreement upon which specific antibiotic, dosage or administration route should be preferred. Since few previous studies have assessed the effectiveness of prophylaxis by direct measurement of antibiotic levels both in plasma and tissue, we designed an experimental study to quantitatively evaluate amoxicillin concentrations in children ready for tonsillectomy and compare these plasma and tissue levels with the Minimal Inhibitory Concentrations (MIC) of the bacteria more commonly involved in the upper airway infections.. Thirty-three pediatric patients under 14 years of age (median 5.0, IQR 4-7, range 3-11; M:F 18:15) with recurrent tonsillitis were treated with 3 doses (established on patient's weight) of amoxicillin-clavulanic acid given orally the day before plus a further dose 2h before tonsillectomy. Amoxicillin concentrations on both homogenated tonsillar cores and plasma were measured by HPLC-UV. Bacterial epidemiology and susceptibility were derived respectively from survey data collected by Microbiology Unit and MIC according to the National Committee for Clinical Laboratory Standards (NCCLS).. Median plasma and tissue amoxicillin concentrations were respectively 4.7 microg/ml (IQR 2.1-8.0; min-max 0.4-14.3) and 1.1 microg/g (IQR 0.4-2.1; min-max 0.4-12.9), considerably below the selected target MIC of pathogens involved in the upper respiratory tract infections (S. aureus, H. influenzae, M. catarrhalis). 20 Children showed undetectable amoxicillin levels in one or both tonsils. Interestingly, 7 out of these patients (35%) had plasma concentrations higher than the target MIC (8 microg/ml). No patient displayed plasma concentrations under the limit of sensitivity of the method. Poor core-plasma and left-right core correlation was observed among patients, suggesting that fibrosis developed after recurrent tonsillitis may hamper antibiotic penetration.. Based upon direct measurement of antibiotic levels in plasma and tissue, this study suggests that a revision of the oral prophylaxis in children is required in order to reduce microbial charge in the operative field and accordingly improve the recovery after tonsillectomy.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacterial Infections; Child; Child, Preschool; Chromatography, High Pressure Liquid; Female; Humans; Male; Microbial Sensitivity Tests; Palatine Tonsil; Postoperative Complications; Tonsillectomy

Human actinomycosis is an infrequent chronic infection caused by gram-positive anaerobic bacteria with predominantly cervicofacial and intestinal manifestation. Retroperitoneal abscess formation displays a very rare localisation and is mostly incidentally diagnosed by histological examination. We report on a 44-year-old woman with left-sided flank pain and retroperitoneal abscess formation diagnosed by CT scan. Case history revealed preceding nephroureterectomy of the left kidney due to loss of kidney function and recurrent ureteral-vaginal fistulas. After CT scan-guided puncture and negative bacterial culture, actinomycosis could only be diagnosed by histopathological examination. Subsequently, besides abscess drainage calculated antibiotic therapeutic regimen was initiated. During the follow-up of 9 months there was no local or systemic recurrence. In the present case report, aetiology, clinical symptoms as well as diagnostic and therapeutic consequences are discussed.

Topics: Abdominal Abscess; Actinomycosis; Adult; Amoxicillin-Potassium Clavulanate Combination; Combined Modality Therapy; Diagnosis, Differential; Drainage; Female; Humans; Infant, Newborn; Kidney Diseases; Kidney Failure, Chronic; Nephrons; Postoperative Complications; Recurrence; Retroperitoneal Space; Tomography, X-Ray Computed; Vesico-Ureteral Reflux

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Drug Administration Schedule; Endoscopy, Gastrointestinal; Gastrostomy; Humans; Postoperative Complications; Practice Guidelines as Topic

Topics: Amoxicillin-Potassium Clavulanate Combination; Anesthetics, Inhalation; Anti-Bacterial Agents; Anti-Inflammatory Agents, Non-Steroidal; Chemical and Drug Induced Liver Injury; Halothane; Humans; Jaundice, Obstructive; Liver Failure, Acute; Liver Transplantation; Postoperative Complications; Sulfonamides; Time Factors

The main objective of this study was to determine whether bacteria cultured from oral swabs taken at the time of surgery predicted postoperative fistula formation.. The study was a prospective longitudinal audit.. The setting was a designated U.K. N.H.S. cleft center.. Subjects consisted of the patients of a single cleft surgeon who were undergoing surgery for cleft palate repair or cleft fistula repair.. Oral microbiological swabs were taken from patients while they were on the operating table just before surgery.. The results from microbiological culture of the swabs were recorded, as was the presence or absence of a fistula at 6 months postoperatively. Additional collected information was related to the severity of the cleft, whether the operating microscope was used during surgery, and whether the patient had developed a postoperative upper respiratory tract infection.. Positive swab cultures were not significantly associated with fistula formation. Use of the operating microscope was not associated with an increase or decrease in the number of fistulas. A fistula developed in all patients who experienced a postoperative upper respiratory tract infection.. The practice of performing routine preoperative mouth swabs should be abandoned because the presence of bacteria in the mouth does not increase the risk of fistula formation.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacteria; Child; Child, Preschool; Cleft Palate; Cohort Studies; Dental Audit; Female; Follow-Up Studies; Humans; Infant; Longitudinal Studies; Male; Microsurgery; Nose Diseases; Oral Fistula; Pharynx; Postoperative Complications; Preoperative Care; Prospective Studies; Respiratory Tract Fistula; Respiratory Tract Infections; Staphylococcus aureus; Streptococcus; Treatment Outcome

Topics: Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bronchi; Cefamandole; Cross-Sectional Studies; Dose-Response Relationship, Drug; Drug Administration Schedule; Humans; Microbial Sensitivity Tests; Pneumonectomy; Pneumonia, Pneumococcal; Postoperative Complications; Pulmonary Disease, Chronic Obstructive; Risk; Treatment Outcome

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Aza Compounds; Fluoroquinolones; Humans; Molar, Third; Moxifloxacin; Postoperative Complications; Quinolines; Randomized Controlled Trials as Topic; Surgical Wound Infection; Time Factors; Tooth Extraction

The recommended antibiotic prophylaxis by second-generation cephalosporins reduces the incidence of wound infection and empyema, but its effectiveness on postoperative pneumonias (POPs) after major lung resection lacks demonstration. We investigated risk factors and characteristics of POPs occurring when antibiotic prophylaxis by second-generation cephalosporin or an alternative prophylaxis targeting organisms responsible for bronchial colonization was used.. An 18-month prospective study on all patients undergoing lung resections for noninfectious disease was performed. Prophylaxis by cefamandole (3 g/24 h, over 48 hours) was used during the first 6 months, whereas amoxicillin-clavulanate (6 g/24 h, over 24 hours) was used during the subsequent 12 months. Intraoperative bronchial aspirates were systematically cultured. Patients with suspicion of pneumonia underwent bronchoscopic sampling for culture.. Included were 168 patients in the first period and 277 patients in the second period. The incidence of POP decreased by 45% during the second period (P = 0.0027). A significant reduction in antibiotic therapy requirement for postoperative infections (P = 0.0044) was also observed. Thirty-day mortality decreased from 6.5% to 2.9% (P = 0.06). Multivariate analysis showed that type of resection, intraoperative colonization, chronic obstructive pulmonary disease, gender, body mass index, and type of prophylaxis were independent risk factors of POP. A case control-study that matched patients of the two periods according to these risk factors (except for antibiotic prophylaxis) confirmed that the incidence of POP was lowered during the second period.. Targeted antibiotic prophylaxis may decrease the rate of POPs after lung resection and improve outcome.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bronchitis; Case-Control Studies; Cefamandole; Cephalosporins; Dose-Response Relationship, Drug; Drug Administration Schedule; Education, Medical, Continuing; Female; Follow-Up Studies; France; Humans; Incidence; Lung Diseases; Male; Middle Aged; Multivariate Analysis; Pneumonectomy; Pneumonia, Bacterial; Postoperative Complications; Preoperative Care; Probability; Prospective Studies; Reference Values; Risk Assessment; Surgical Wound Infection; Survival Rate

We report the case of a 52-year-old man, ASA 3-4, malnourished, heavy smoker and drinker at the stage of chronic obstructive pulmonary disease and cirrhosis. The postoperative course of a cervical cancer surgery was complicated by a pneumonia with fatal outcome in the intensive care unit. Taking into account the patient's history and surgical requirements, this nosocomial infection did not appear easily preventable. The multiple risk factors and the few preventive measures usable were analyzed. In this context, the media and legal trend to make the doctors responsible for the nosocomial infections should be revised.

Topics: Alcoholism; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Carcinoma, Squamous Cell; Ciprofloxacin; Cross Infection; Disease Susceptibility; Fatal Outcome; Humans; Iatrogenic Disease; Immunocompromised Host; Liver Cirrhosis, Alcoholic; Male; Malnutrition; Malpractice; Middle Aged; Mouth; Neck Dissection; Neoplasm Recurrence, Local; Oxygen; Penicillanic Acid; Piperacillin; Piperacillin, Tazobactam Drug Combination; Pneumonia; Postoperative Complications; Pulmonary Disease, Chronic Obstructive; Risk Factors; Smoking; Tongue Neoplasms

Topics: Adult; Amoxicillin-Potassium Clavulanate Combination; Biopsy; Colitis, Ulcerative; Colon; Diagnosis, Differential; Fever; Humans; Male; Pilonidal Sinus; Postoperative Complications; Purpura; Retinal Vasculitis; Skin; Thrombophlebitis; Vasculitis; Vision Disorders

The spore-forming anaerobic bacterium Clostridium difficile has become a serious enteropathogen. Oral and parenteral administration of antibiotics can cause ecological disturbances in the normal intestinal microflora. Suppression of the normal microflora may lead to reduced colonization resistance with subsequent overgrowth by pre-existing, naturally resistant microorganisms, such as C. difficile. C. difficile infection shows a range of clinical presentations between an asymptomatic carrier state, light diarrhea without inflammatory changes, and pseudomembranous colitis. C. difficile infection is acquired by the fecal-oral or environmental-oral routes. From March 2000 through March 2001 we assessed 48 cases of nosocomial antibiotic-associated diarrhea (AAD). Of these, 21 were due to C. difficile (CDAD). Cephalosporin was the agent most commonly associated with CDAD. Avoidance of cephalosporins, strict use of "single shot" prophylaxis, isolation of infected, symptomatic patients in single-bed rooms, improved hygiene and complete room disinfection lead to a rapid decrease of CDAD. The etiology, prognosis and prophylaxis are discussed in this paper.

Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Cefuroxime; Clostridioides difficile; Colectomy; Colonoscopy; Combined Modality Therapy; Diarrhea; Enterocolitis, Pseudomembranous; Fatal Outcome; Hematoma; Humans; Intestinal Mucosa; Male; Postoperative Complications; Staphylococcal Infections; Superinfection

Postsurgical adhesion formation is a common occurrence after most surgical procedures and is still a major cause of postoperative morbidity because no satisfactory treatment or prophylaxis has yet been developed. Further elucidation of the basic mechanisms of postsurgical adhesion formation is needed. Recent studies using germfree rats have found the indigenous bowel flora to be important in the adhesive response. The present study examined whether antibiotic treatment affects intra-abdominal adhesion formation.. Using the cecal crush model to inflict adhesions, groups of rats ( n=12) were treated with placebo or amoxicillin/clavulanic acid in the drinking water. Treatment started 3 days before operation and continued until evaluation. Adhesion scores were recorded after 7 days. Bacterial counts were made from cultures of fecal samples on operation day and at termination.. Amoxicillin/clavulanic acid decreased adhesion score compared to placebo. Adhesion incidence was 50% in the treatment group and 92% in the placebo group. Bacterial numbers were lower in the treatment group.. Antibiotic treatment which lowers bacterial numbers can decrease adhesions.

Topics: Abdomen; Amoxicillin-Potassium Clavulanate Combination; Animals; Drug Therapy, Combination; Female; Male; Peritoneal Diseases; Postoperative Complications; Random Allocation; Rats; Rats, Inbred Strains; Tissue Adhesions

The use of systemic antibiotic prophylaxis in lacrimal drainage surgery is controversial. Some studies have reported high rates of postoperative infection and surgical failure after lacrimal drainage surgery when systemic antibiotic prophylaxis was not routinely administered. Many ophthalmologists have traditionally used antibiotics only in selected patients undergoing dacryocystorhinostomy (DCR), and this study evaluates the success of this strategy.. This was a retrospective interventional case series of 138 consecutive patients who underwent 163 external DCR procedures. Antibiotics were given only when inflammatory signs were present in the medial canthal region or when purulent material was noted during surgery. Patients with persistent external medial canthal inflammatory signs received amoxicillin/clavulanate or cephalexin orally 3 to 7 days before and 1 week after surgery. Patients in whom purulent lacrimal sac material was noted during surgery received cefazolin intravenously.. Postoperative results were evaluated in terms of wound infection and related complications and surgical success. Systemic antibiotics were given in 15 of 163 (9%) cases. Nine (6%) cases received intraoperative (intravenous) antibiotics; 5 (3%) cases received perioperative (oral) antibiotics; and 1 (1%) case received both. None of the patients had postoperative deep soft tissue infection (cellulitis). Skin changes compatible with superficial wound infection occurred in 2 (1%) cases and responded well to topical treatment. Surgery was successful in 157 of 163 (96%) cases. Of 6 failures, none were associated with postoperative wound infection.. Selective use of antibiotics limited to patients with signs of lacrimal sac inflammation appears sufficient to prevent soft tissue infection after DCR.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibiotic Prophylaxis; Cefazolin; Cephalexin; Child; Child, Preschool; Dacryocystorhinostomy; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Postoperative Complications; Retrospective Studies; Surgical Wound Infection

Frequency of postoperation complications at oncological patients deviates in the range from 10 to 70 per cent. The highest frequency of infectious complications is registered after extended and complex operations (cervical carcinoma, cancer of vulva, ovarian cancer). The most frequent aerobic pathogens in oncology are enterococci, staphylococci and streptococci, in the case of urinary tract operations--enterococci and Erscherichia coli. Perioperation prophylaxis with amoxycillin/clavulanate (Augmentin) effective against this microorganisms and also against anaerobic bacteria (usual pathogens of post operation infections in oncogynecology) resulted with lower frequency of wound infections. Demonstrated prophylaxy efficacy was more potent than that of cefotaxime (p < 0.05) or when compared to results of other antibiotics administration after operations only.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Female; Genital Neoplasms, Female; Humans; Middle Aged; Postoperative Complications; Surgical Wound Infection

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Doxycycline; Drug Therapy, Combination; Female; Fever; Humans; Middle Aged; Pasteurella Infections; Pasteurella multocida; Postoperative Complications; Respiration, Artificial; Respiratory Distress Syndrome

The records of 196 women who underwent colposuspension for genuine stress incontinence at the Leicester General Hospital, England, between June 1991 and May 1996 were reviewed for evidence of urinary tract infection (UTI). Variables analyzed include age, type of antibiotic, timing of a positive culture, organism(s) responsible and antibiotic sensitivity. Forty-six patients (23.47%) developed urinary infection; of these, 42 had received single-dose antibiotic prophylaxis with suprapubic catheterization. Thirty-two (76%) of those who developed UTI received augmentin (amoxycillin and clavulanic acid), whereas 10 (24%) were given cefuroxime and metronidazole. Positive cultures were obtained between postoperative days 3 and 28, with a mean of 9.6 days, and 81% occurred after the 7th day. Coliform organisms were responsible for nearly 70% of the infections. UTI is still common after colposuspension, despite single-dose antibiotic prophylaxis. Further studies looking at longer or alternative courses of antibiotics or clean intermittent self-catheterization are essential to establish the best way of curbing UTI in urogynecology patients.

Topics: Adult; Aged; Aged, 80 and over; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacteriuria; Cefuroxime; Female; Humans; Metronidazole; Middle Aged; Postoperative Complications; Risk Factors; Treatment Outcome; Urinary Incontinence, Stress; Urinary Tract Infections

A 53-year-old patient had a prosthetic valve (St. Jude Medical 25) 9 years ago because of a Staphylococcus aureus endocarditis with severe aortic regurgitation. An initially mild, progressively more severe, aortic regurgitation then developed as a result of an empty paravalvular abscess cavity, requiring another valve replacement. Fever started on the 3rd postoperative day and persisted despite combined treatment with beta-lactam antibiotics and aminoglycoside.. At first no infectious focus could be identified radiologically or by echocardiography. But transoesophageal echocardiography revealed vegetations in the old abscess cavity. Several blood cultures were negative, while serological tests gave markedly raised antibody titers against Coxiella burnetii.. Assuming Coxiella burnetii endocarditis the patient was given doxycycline, 2 x 100 mg daily and cotrimoxazole, 1 x 960 mg daily. The fever subsided and the vegetations had disappeared after four weeks. Because of the high risk of recurrence the antibiotic treatment was to be continued for two years.. Coxiella burnetii should be considered as a possible cause of fever of unknown origin, especially in patients with existing or operated cardiac valvar defects, when endocarditic vegetations have been demonstrated and several blood cultures have been negative.

Topics: Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Antibodies, Bacterial; Aortic Valve; Aortic Valve Insufficiency; Coxiella burnetii; Doxycycline; Drug Therapy, Combination; Echocardiography, Transesophageal; Endocarditis, Bacterial; Gentamicins; Heart Valve Prosthesis Implantation; Humans; Male; Middle Aged; Postoperative Complications; Q Fever; Recurrence; Reoperation; Treatment Failure; Trimethoprim, Sulfamethoxazole Drug Combination

In two patients, men aged 35 and 69 years admitted postoperatively to the intensive care unit, fever of unknown origin developed. One had been admitted because aspiration was suspected. He had been treated immediately with amoxicillin and clavulanic acid. The other had undergone oesophageal excision and gastric reconstruction because of oesophageal carcinoma and had been subjected to antibiotic decontamination (amphotericin B, norfloxacine en fungizone). No cause for the fever was detected, but it quickly subsided after discontinuation of the amoxicillin-clavulanic acid and the norfloxacine, respectively. When encountering fever of unknown origin in intensive care patients it is always important to think of drug fever.

Topics: Adult; Aged; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Drug Hypersensitivity; Drug Therapy, Combination; Esophageal Diseases; Fever of Unknown Origin; Humans; Intensive Care Units; Male; Norfloxacin; Postoperative Complications; Suction; Treatment Outcome

Amoxycillin-clavulanate was used in prophylaxis of infectious complications after abdominal hysterectomy. A group of 29 patients was treated routinely with metronidazol introduced vaginally 2-3 days before surgery. This group was compared with 40 patients who received two perioperative doses of Augmentin intravenously. The incidence of febrile morbidity, urinary tract infection, following antibiotic treatment and pelvic infection were followed in both groups. Patients in the amoxycillin-clavulanic acid group had significantly less infectious morbidity than those in the metronidazol group. The results suggest that antibiotic prophylaxis for abdominal hysterectomy is effective. The prophylactic agent should be bactericide against aerobic and anaerobic bacteria and non-toxic. Amoxycillin-clavulanate (Augmentin) meets all these criteria.

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Antibiotic Prophylaxis; Bacterial Infections; Clavulanic Acids; Drug Therapy, Combination; Female; Humans; Hysterectomy; Middle Aged; Postoperative Complications

In a group of 340 patients subjected to colorectal surgery for antimicrobial prophylaxis amoxicillin clavulanate (Augmentin) or ornidazole (Tiberal) was used, in both instances as short-term monoprophylaxis. To test the effectiveness of prophylaxis, the clinical results were evaluated, expressed by the number of infectious complications, as well as serum and tissue levels of the two preparations used for prophylaxis. In serum and tissue they reached the MIC level of the tested microbial spectrum; an inadequate level was found in all probands in subcutaneous adipose tissue. The clinical result of 4.8% infectious complications when using ornidazole and 3.2% when using amoxicillin clavulante resp. is considered as evidence of the effectiveness and correct selection of preparations and also of sufficient short-term prophylaxis.

Topics: Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acids; Colon; Drug Therapy, Combination; Female; Humans; Male; Middle Aged; Ornidazole; Postoperative Complications; Premedication; Rectum

Guided tissue regeneration procedures with Gore-Tex Periodontal Material are associated with a unique set of postoperative healing characteristics. Five healing complications are described in this study examining 102 sites. The occurrence of pain and purulence were the most common. In purulent sites, the majority of bacteria cultured were Actinomyces and Streptococcus spp. Resistance to antibiotics was common. Prevention and treatment of the healing complications are discussed.

Topics: Actinomyces; Adolescent; Adult; Aged; Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Chi-Square Distribution; Clavulanic Acids; Doxycycline; Drug Resistance, Microbial; Drug Therapy, Combination; Edema; Female; Furcation Defects; Gingival Diseases; Guided Tissue Regeneration, Periodontal; Humans; Male; Membranes, Artificial; Microbial Sensitivity Tests; Middle Aged; Pain, Postoperative; Periodontitis; Polytetrafluoroethylene; Postoperative Complications; Prevotella intermedia; Streptococcus; Suppuration; Surgical Flaps; Wound Healing

Topics: Amoxicillin; Amoxicillin-Potassium Clavulanate Combination; Clavulanic Acid; Clavulanic Acids; Drug Therapy, Combination; Endometrium; Fallopian Tubes; Female; Genital Diseases, Female; Half-Life; Humans; Myometrium; Ovary; Postoperative Complications; Preoperative Care; Tissue Distribution