scholarly journals The Risk-Benefit Ratio of Leech Therapy: A Single-Center Retrospective Study

2021 ◽  
Author(s):  
A. Fillatre ◽  
Q. Floug ◽  
N. Assaf ◽  
R. Sinna ◽  
K. Hedhli ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Antibiotic Treatment ◽  
Reconstructive Surgery ◽  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Venous Congestion ◽  
University Hospital ◽  
Leech Therapy ◽  
Prophylactic Antibiotic Treatment

Abstract Background: Venous congestion in transplanted or replanted tissues remains a common and challenging complication of plastic and reconstructive surgery. The local application of medicinal leeches is effective in reducing postoperative venous congestion in skin flaps and restoring normal blood flow. However, leech therapy is associated with a number of risks, including infections; in order to digest blood, leeches have a symbiotic relationship with Aeromonas species in their gut. Aeromonas infections are associated with a dramatic decrease in flap salvage rates. This is why prophylactic antibiotic treatment and external decontamination of the leeches are widely recommended. Methods: We performed a single retrospective study of patients having undergone leech therapy between January 1st, 2010, and December 31st, 2018, at Amiens-Picardie University Hospital, France. Each patient’s medical history, clinical data, laboratory results, prophylactic antibiotic use, and complications were recorded.Results: A total of 37 patients (mean age: 47) had undergone leech therapy after reconstructive surgery. Antimicrobial prophylaxis was documented in 32 (84.6%) patients. However, there are no guidelines on the choice of prophylactic antibiotic treatment. Twenty-four of the 37 (64.8 %) patients had anemia (mean hemoglobin level: 8.5 (6-11.1) g/dL), and 13 of the 24 (54%) required a transfusion. Thirteen of the 37 patients (35.1%) had a post-operative infection mainly due to Aeromonas spp. (76.9%). Leech therapy was effective in 23 of the 37 patients (62%) overall and in 2 of the 10 patients (20%) with an Aeromonas infection. The association between Aeromonas infection and flap salvage failure was highly significant (p = 0.005).Conclusions: The results of the study emphasized that clinical bacteriologists and surgeons should be aware that leeches are potential sources of infection.

Prophylactic Antibiotic Reduces the Risk of Peritonitis after Invasive Gynecologic Procedures

2019 ◽  
Vol 39 (4) ◽  
pp. 356-361
Author(s):  
Pei-Yi Fan ◽  
Ming-Jen Chan ◽  
Sheng-Hsuan Lin ◽  
Hsin-Hsu Wu ◽  
Ming-Yang Chang ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Medical Center ◽  
Demographic Data ◽  
Group B Streptococcus ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Streptococcus Group ◽  
Prophylactic Antibiotic Treatment ◽  
Group B ◽  
Invasive Techniques

BackgroundPeritonitis is a serious complication after invasive procedures in patients undergoing peritoneal dialysis (PD). Most studies that have investigated peritonitis following invasive gynecologic procedures enrolled small patient populations. This study focuses on the clinical presentation, outcomes, and effects of prophylactic antibiotic use before invasive techniques.MethodsA retrospective study was conducted on patients who underwent invasive gynecologic procedures between 2005 and 2015 in a tertiary medical center. Eligible patients were identified and enrolled and their demographic data were collected. The use of prophylactic antibiotics and the outcomes of peritonitis were recorded.ResultsTwenty-six gynecologic procedures were performed on 18 PD patients. Seven episodes of peritonitis occurred in 6 patients after invasive gynecologic procedures. Eleven procedures were preceded by prophylactic antibiotic treatment (6 oral cefadroxil, 1 oral cefuroxime, 1 oral clindamycin, 1 intravenous [IV] ceftriaxone, 1 IV ceftazidime, and 1 IV cefazolin). The pathogens were diverse (group B Streptococcus, group D Streptococcus, E. coli, and Enterococcus). All episodes of peritonitis were successfully treated using intraperitoneal antibiotics without recurrence, technique failure, or mortality. The odds ratio of peritonitis in the non-prophylaxis group was 20.29 (95% confidence interval 1.01 – 406.35, p = 0.0103).ConclusionThe use of prophylactic antibiotic treatment considerably reduced the risk of peritonitis after invasive gynecologic procedures.

The effect of prophylactic antibiotic treatment for manual removal of the placenta on frequency of postpartum endometritis

2017 ◽  
Vol 139 (1) ◽  
pp. 45-49 ◽  
Author(s):  
Myriam Safrai ◽  
Doron Kabiri ◽  
Rani Haj-Yahya ◽  
Adi Reuveni-Salzman ◽  
Michal Lipschuetz ◽  
...  
Keyword(s):  
Antibiotic Treatment ◽  
Prophylactic Antibiotic ◽  
Manual Removal ◽  
Prophylactic Antibiotic Treatment

scholarly journals Antibiotic Prophylaxis in Orbital Fractures

2017 ◽  
Vol 11 (1) ◽  
pp. 11-16 ◽  
Author(s):  
Benjamin Reiss ◽  
Lamise Rajjoub ◽  
Tamer Mansour ◽  
Tony Chen ◽  
Aisha Mumtaz
Keyword(s):  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
University Hospital ◽  
Orbital Fracture ◽  
Number Needed To Treat ◽  
Orbital Fractures ◽  
Oral Antibiotics ◽  
George Washington ◽  
Amoxicillin Clavulanate ◽  
Trauma Teams

Purpose: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection. Design: Retrospective cohort study. Participants: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics. Main Outcome Measures: Development of orbital infection. Results: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received intravenous (IV) antibiotics (excluding cefazolin). Cephalexin and amoxicillin-clavulanate were the most prescribed oral antibiotics that are equally effective. Five-to-seven day courses of antibiotics had no increased infections compared to ten-to-fourteen day courses. Calculated boundaries for effectiveness of prophylactic antibiotics ranged from a Number Needed to Treat (NNT) of 75 to a Number Needed to Harm (NNH) of 198. Conclusion: Antibiotics for prevention of orbital infection in patients with orbital fractures have become widely used. Coordination between trauma teams and specialists is needed to prevent patient overmedication and antibiotic resistance. Should antibiotics be used, shorter courses and avoidance of broad spectrum agents are recommended. Additional studies are needed.

scholarly journals Assessment of Prophylactic Antibiotic Use in Patients with Surgical Site Infections

2013 ◽  
Vol 48 (7) ◽  
pp. 560-567 ◽  
Author(s):  
Whitney J. Goede ◽  
Jenna K. Lovely ◽  
Rodney L. Thompson ◽  
Robert R. Cima
Keyword(s):  
Antimicrobial Prophylaxis ◽  
Prophylactic Antibiotic ◽  
Surgical Care ◽  
Control Unit ◽  
Surgical Site Infections ◽  
Perioperative Period ◽  
Antibiotic Use ◽  
Infection Prevention And Control ◽  
Improvement Project ◽  
Antibiotic Selection

Background Surgical site infections (SSIs) are the leading cause of hospital-acquired infections and are associated with substantial health care costs, with increased morbidity and death. The Surgical Care Improvement Project (SCIP) contains standards that are nationally reported with the aim of improving patient outcomes after surgery. Our institution's standards for antimicrobial prophylaxis in the perioperative period are more stringent than these measures and may be considered “beyond SCIP.” The 4 elements of appropriate antimicrobial prophylaxis are timing, antibiotic selection, dosing, and intraoperative redosing. Objective To quantify antimicrobial SSI prophylaxis compliance in accordance with institutional standards and to identify potential opportunities for improvement. Methods Patients aged 18 years or older were included if they had an SSI between January 1, 2009, and June 30, 2010, according to the database maintained prospectively by the Infection Prevention and Control Unit. Adherence to our institution's practice standards was assessed through analysis of antibiotics administered—timing in relation to the incision, closure, and tourniquet inflation times for the procedure and antibiotic selection, dose, and redosing. Results Overall noncompliance with all 4 elements of antimicrobial prophylaxis was 75.4% among the 760 cases. Repeat dosing had the greatest noncompliance (45.1%); antibiotic selection had the lowest incidence of noncompliance (10.8%). Conclusions Noncompliance existed in each element of antimicrobial SSI prophylaxis, with antibiotic redosing leading in noncompliance. With the implementation of tools to assist the surgical team in following institutional standards, noncompliance will likely decline and additional research opportunities will exist.

Prophylactic Antibiotic Treatment Prevents Infection after Cardiopulmonary Bypass: A Study in Dogs

1987 ◽  
Vol 43 (5) ◽  
pp. 544-549 ◽  
Author(s):  
Willem van Oeveren ◽  
Jacob Dankert ◽  
Walter Wildevuur ◽  
Charles R.H. Wildevuur
Keyword(s):  
Cardiopulmonary Bypass ◽  
Antibiotic Treatment ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotic Treatment
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