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 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.

Endoscopic-Assisted Orbital Floor Reconstruction: the First Two Cases in Vietnam

2018 ◽  
Vol 8 (3) ◽  
Author(s):  
Trung Trực Vũ ◽  
Mai Anh Bui
Keyword(s):  
Endoscopic Surgery ◽  
University Hospital ◽  
Orbital Floor ◽  
Facial Trauma ◽  
Orbital Fracture ◽  
Viet Nam ◽  
Orbital Fractures ◽  
Surgical Indications ◽  
Orbital Floor Reconstruction

Tóm tắt Vỡ xương ổ mắt là một bệnh cảnh phối hợp trong chấn thương hàm mặt và chấn thương sọ mặt. Các biến chứng thường gặp nhất là lõm ổ mắt, song thị và kẹt cơ vận nhãn để lại ảnh hưởng nặng nề cả về chức năng và tâm lý. Điều trị có thể được thực hiện bởi nhiều chuyên khoa, tuy nhiên kỹ thuật và chỉ định vẫn còn nhiều bàn cãi. Tác giả thông báo hai trường hợp đầu tiên ở Việt Nam được tạo hình sàn ổ mắt sau chấn thương với nội soi hỗ trợ tại Bệnh viện Hữu nghị Việt Đức năm 2016. Abstract Orbital fractures are a combination of facial jaw injuries and face skull injuries. The most common complications are enophthalmos, diplopia and muscle entrapment that leave a bad effect on both funtion and psychology. Treatment can be done by various specialists, howeverthe technique and surgical indications are still controversial. The authors report the first two cases in Vietnam which were reconstructed of the orbital floor with endoscopic-assisted at VietDuc University Hospital in 2016. Keyword: Orbital fracture, facial trauma, enophthalmos, orbital floor reconstruction, endoscopic surgery.

scholarly journals Should We Use Antibiotic Prophylaxis for Flexible Cystoscopy? A Systematic Review and Meta-Analysis

2015 ◽  
Vol 95 (3) ◽  
pp. 249-259 ◽  
Author(s):  
Michelle M. Carey ◽  
Abdullah Zreik ◽  
Neil J. Fenn ◽  
Piotr L. Chlosta ◽  
Omar M. Aboumarzouk
Keyword(s):  
Systematic Review ◽  
Antibiotic Prophylaxis ◽  
Meta Analysis ◽  
Asymptomatic Bacteriuria ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Control Group ◽  
Number Needed To Treat ◽  
Flexible Cystoscopy ◽  
Antibiotic Group

Introduction: The role of antibiotic prophylaxis for routine flexible cystoscopy (FC) is not clear due to the varying practices of individual clinicians. There are no formal guidelines, and this may be due to a lack of formal summary of the data. Methods: A systematic review was conducted in April 2014 including all randomised control trials on prophylactic antibiotic use for FC. The main outcome measures were confirmed bacteriuria on mid-stream urine (MSU), asymptomatic bacteriuria and symptomatic bacteriuria. A meta-analysis was conducted with difference between groups expressed as an odds ratio (OR) and control group risk. Results: 5,107 patients were included, 2,173 in placebo and 2,934 in the antibiotic group. The OR for all three outcomes favoured the antibiotic group; the risk of developing symptomatic bacteriuria was 0.06 times more likely in the control group (OR 0.34), 0.054 (OR 0.40) for developing asymptomatic bacteriuria and 0.109 for confirming bacteriuria on MSU (OR 0.36). The number needed to treat (NNT) was 15 (13-19) for MSU positive bacteriuria; 32 (27-42) for symptomatic bacteriuria and 26 (23-33) for asymptomatic bacteriuria. Conclusions: Antibiotic prophylaxis did confer a reduction in cases of symptomatic and asymptomatic bacteriuria but the NNT were high. Therefore, the authors cannot advocate the use of antibiotic prophylaxis for routine FC procedures.

A Survey of Prophylactic Antibiotic Use for Total Joint Replacements in a Community Hospital

1985 ◽  
Vol 19 (10) ◽  
pp. 753-757 ◽  
Author(s):  
Edward P. Armstrong ◽  
Daniel L. Kopp
Keyword(s):  
Private Practice ◽  
Community Hospital ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Generation Cephalosporin ◽  
Prophylactic Antibiotics ◽  
Oral Antibiotics ◽  
Joint Replacements ◽  
Total Joint Replacements ◽  
Orthopedic Surgeons

This study was conducted in a nonteaching community hospital to characterize the use of prophylactic antibiotics in patients undergoing total joint replacements by orthopedic surgeons in private practice. Of the 101 patients studied, 43 were started on antibiotics too early, 32 were left on the drugs for too long a period, and 33 received subsequent oral antibiotics without identifiable reason. Seventy-nine (78.2 percent) received 8 g/d of a first- or second-generation cephalosporin for prophylaxis. None of the patients received cefazolin 1 g q8h.

Is perioperative antibiotic necessary in straightforward implant placement procedures?

2020 ◽  
Author(s):  
Elçin Bedeloğlu ◽  
Mustafa Yalçın ◽  
Cenker Zeki Koyuncuoğlu
Keyword(s):  
Clavulanic Acid ◽  
Dental Implant ◽  
Prophylactic Antibiotic ◽  
Antibiotic Use ◽  
Implant Failure ◽  
Control Group ◽  
Implant Placement ◽  
Significant Difference ◽  
Amoxicillin Clavulanic Acid ◽  
Experimental Group

The purpose of this non-random retrospective cohort study was to evaluate the impact of prophylactic antibiotic on early outcomes including postoperative pain, swelling, bleeding and cyanosis in patients undergoing dental implant placement before prosthetic loading. Seventy-five patients (45 males, 30 females) whose dental implant placement were completed, included to the study. Patients used prophylactic antibiotics were defined as the experimental group and those who did not, were defined as the control group. The experimental group received 2 g amoxicillin + clavulanic acid 1 h preoperatively and 1 g amoxicillin + clavulanic acid twice a day for 5 days postoperatively while the control group had received no prophylactic antibiotic therapy perioperatively. Data on pain, swelling, bleeding, cyanosis, flap dehiscence, suppuration and implant failure were analyzed on postoperative days 2, 7, and 14 and week 12. No statistically significant difference was detected between the two groups with regard to pain and swelling on postoperative days 2, 7, and 14 and week 12 ( p >0.05), while the severity of pain and swelling were greater on day 2 compared to day 7 and 14 and week 12 in both groups ( p =0.001 and p <0.05, respectively). Similarly, no significant difference was found between the two groups with regard to postoperative bleeding and cyanosis. Although flap dehiscence was more severe on day 7 in the experimental group, no significant difference was found between the two groups with regard to the percentage of flap dehiscence assessed at other time points. Within limitations of the study, it has been demonstrated that antibiotic use has no effect on implant failure rates in dental implant surgery with a limited number of implants. We conclude that perioperative antibiotic use may not be required in straightforward implant placement procedures. Further randomized control clinical studies with higher numbers of patients and implants are needed to substantiate our findings.

scholarly journals Multidisciplinary Unit Improves Pregnancy Outcomes in Women with Rheumatic Diseases and Hereditary Thrombophilias: An Observational Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1487
Author(s):  
Isabel Añón-Oñate ◽  
Rafael Cáliz-Cáliz ◽  
Carmen Rosa-Garrido ◽  
María José Pérez-Galán ◽  
Susana Quirosa-Flores ◽  
...  
Keyword(s):  
High Risk ◽  
Observational Study ◽  
Medical Care ◽  
Pregnant Women ◽  
Rheumatic Diseases ◽  
Absolute Risk ◽  
University Hospital ◽  
Obstetric Outcomes ◽  
Number Needed To Treat ◽  
Foetal Death

Rheumatic diseases (RD) and hereditary thrombophilias (HT) can be associated with high-risk pregnancies. This study describes obstetric outcomes after receiving medical care at a multidisciplinary consultation (MC) and compares adverse neonatal outcomes (ANOs) before and after medical care at an MC. This study is a retrospective observational study among pregnant women with RD and HT treated at an MC of a university hospital (southern Spain) from 2012 to 2018. Absolute risk reduction (ARR) and number needed to treat (NNT) were calculated. A total of 198 pregnancies were registered in 143 women (112 with RD, 31 with HT), with 191 (96.5%) pregnancies without ANOs and seven (3.5%) pregnancies with some ANOs (five miscarriages and two foetal deaths). Results previous to the MC showed 60.8% of women had more than one miscarriage, with 4.2% experiencing foetal death. MC reduced the ANO rate by AAR = 60.1% (95%CI: 51.6−68.7%). The NNT to avoid one miscarriage was 1.74 (95%CI: 1.5–2.1) and to avoid one foetal death NNT = 35.75 (95CI%: 15.2–90.9). A total of 84.8% of newborns and 93.2% of women did not experience any complication. As a conclusion, the follow-up of RD or HT pregnant women in the MC drastically reduced the risk of ANOs in this population with a previous high risk.

scholarly journals Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Junya Kusumoto ◽  
Atsushi Uda ◽  
Takeshi Kimura ◽  
Shungo Furudoi ◽  
Ryosuke Yoshii ◽  
...  
Keyword(s):  
Educational Intervention ◽  
Oral Surgery ◽  
Maxillofacial Surgery ◽  
Antibiotic Use ◽  
Oral And Maxillofacial Surgery ◽  
Third Generation ◽  
Oral Antibiotics ◽  
Appropriate Use ◽  
Before And After ◽  
Third Generation Cephalosporins

Abstract Background In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital. Methods The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018. Results After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466). Conclusions This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.

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