Incidence of postpartum endomyometritis following single-dose antibiotic prophylaxis with either ampicillin/sulbactam, cefazolin, or cefotetan in high-risk cesarean section patients

Introduction. The aim of our study was to determine whether a single-dose preoperative administration of antibiotics was sufficient to prevent intra and postoperative infections in the parturients without a high risk of developing an infection, in whom the delivery was completed by cesarean section, as well as to answer whether the administered dose of antibiotics satisfied the requirements of therapeutic concentrations necessary to protect against infection in the period during the surgical procedure and during the first 6 postoperative hours. Material and methods. All investigated pregnant women were planned to have elective cesarean section as a mode of delivery. They were distributed in groups depending on the type (cephalexin, gentamycin and cephazolin) of antibiotic prophylaxis administered as a single dose. In all patients the clinical postoperative course was followed for possible infection. The concentrations of antibiotics were estimated immediately and 6h following the operation. The estimation of antibiotic concentrations was done by the method of liquid chromatography (for antibiotics belonging to the group of cephalosporins), i.e. RIA method for antibiotics from the group of aminoglycosides. Results and conclusion. The total number of infections in investigated groups was 5.18%. The measured mean concentrations of administered antibiotics following the operation and 6 h later were above MIC. This is a proof that the obtained antibiotic prophylaxis by a single dose administration of anbtibiotic is sufficient to prevent the invasion of pathogenic microorganisms from the skin.

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Current routines for antibiotic prophylaxis prior to transrectal prostate biopsy: a national survey to all urology clinics in Sweden

F1000Research ◽

10.12688/f1000research.19260.1 ◽

2020 ◽

Vol 9 ◽

pp. 58 ◽

Cited By ~ 1

Author(s):

Johan Styrke ◽

Sven Resare ◽

Karl-Johan Lundström ◽

Patrick Masaba ◽

Christofer Lagerros ◽

...

Keyword(s):

Single Dose ◽

High Risk ◽

Antibiotic Prophylaxis ◽

Prostate Biopsy ◽

High Risk Patient ◽

Guideline Recommendation ◽

Risk Of Infection ◽

Urine Dipstick ◽

Number Of Patients ◽

Increased Risk

Background: The risk of infection after transrectal ultrasound (TRUS)-guided prostate biopsies is increasing. The aim of the study was to assess the use of antibiotic prophylaxis for prostate biopsy in Sweden. Methods: All public and private urology clinics reporting to the National Prostate Cancer Register of Sweden received a survey on TRUS-biopsy prophylaxis. Results: Of the 84 clinics surveyed, 76 replied (90%). If no risk factors for infection were present, a single dose of ciprofloxacin 750 mg was used by 50 clinics (66%). Multiple doses of ciprofloxacin 500 or 750 mg (n=14; 18%) or a single dose of trimethoprim-sulfamethoxazole 160/800 mg (n=7; 9%) were other common prophylaxes. Most clinics gave the prophylaxes immediately before the biopsy (n=41; 54%). Urine dipstick was used by 30 clinics (39%) and rectal enema by six (8%). In patients with high risk of infection, the survey mirrors a large variety of regiments used. Conclusions: The preference to use a single dose of ciprofloxacin 750 mg is in accordance with the Swedish national guidelines for patients with a low risk of infection. Better compliance to the guideline recommendation to use a urine dipstick would probably increase the number of patients classified as having an increased risk of infection. Being classified as a high-risk patient should lead to an extended duration of antibiotic prophylaxis, however, the variety of regimens used in the high-risk group reflects an inability to treat these patients in a standardized fashion and also highlights a need for more clear-cut guidelines. Pre-biopsy identification of high-risk patients is an important issue to tackle for the urologic clinics in order to reduce the number of infections.

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Single-dose cefotetan versus multidose cefoxitin for prophylaxis in cesarean section in high-risk patients

American Journal of Obstetrics and Gynecology ◽

10.1016/0002-9378(86)90497-7 ◽

1986 ◽

Vol 154 (4) ◽

pp. 955-960 ◽

Cited By ~ 23

Author(s):

James A. McGregor ◽

Janice I. French ◽

Edgar Makowski

Keyword(s):

Single Dose ◽

High Risk ◽

Cesarean Section ◽

High Risk Patients ◽

Risk Patients

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Cost of Antibiotic Prophylaxis in Cesarean Section

Drug Intelligence & Clinical Pharmacy ◽

10.1177/106002808602000719 ◽

1986 ◽

Vol 20 (7-8) ◽

pp. 592-593 ◽

Cited By ~ 4

Author(s):

Larry C. Ford

Keyword(s):

High Risk ◽

Cesarean Section ◽

Antibiotic Prophylaxis ◽

Cost Savings ◽

High Failure Rate ◽

Antibiotic Agent ◽

Significant Cost ◽

Effective Prophylaxis ◽

Risk Patients ◽

To Receive

Two hundred sixty-three patients were randomly assigned to receive either piperacillin or cefoxitin for prophylaxis in cesarean section. Although both drugs were considered effective, piperacillin achieved a level of 98 percent satisfactory prophylaxis compared with only 91 percent for cefoxitin. Costs of prophylactic failure in cesarean section were calculated and then assessed for four different antibiotic regimens (based on 100 patients). Because of its high failure rate, ampicillin was the most expensive antibiotic; piperacillin was the least expensive. It was suggested that highly effective prophylaxis with an antibiotic agent such as piperacillin can result in significant cost savings when used for high-risk patients undergoing cesarean section.

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