scholarly journals The role of prophylactic antibiotics in compound facial fractures treated by closed and open reduction

2019 ◽  
Vol 31 (3) ◽  
pp. 17-23
Author(s):  
Thamir Y. Hammadi ◽  
Thair Abdul Lateef
Keyword(s):  
Open Reduction ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Current Evidence ◽  
Facial Fractures ◽  
Eligibility Criteria ◽  
Closed Treatment ◽  
Group B ◽  
Clean Contaminated

Background: The role of prophylactic antibiotics remains controversial. It is clear that actively facial fractures are considered as clean contaminated and should be treated with therapeutic antibiotics; however, there is widespread variability in the use, type, timing, and duration of prophylactic antibiotic administrated in practice today. There is an adverse effect of increased antibiotic resistance, as well as costs, it is important to review the current evidence for the role of prophylactic antibiotics in compound facial fractures. The purpose of this study is to evaluate the role and significance of preoperative, perioperative and postoperative antibiotic prophylaxis for patients when there is already an infective focus, such as compound facial fracture. Materials and methods: A total of 70 Iraqi patients aged 4-65 years, 50 males and 20 females who met the eligibility criteria were enrolled in this study to evaluate the infection rate in patients who have sustained compound facial fractures treated by open or closed treatment. The patients were divided into two groups, Group A included 50 patients who received pre, peri and post-operative antibiotics. Postoperatively the antibiotics utilized in two different regimen timing. In Group B antibiotics were administrated peri and post-operatively for 20 patients. They were then followed up to 4 weeks for any sign or evidence of infection such as pus discharge. Results: There was no significant association (p=0.664) between the incidence of post-operative infections and pre-operative administration of antibiotics. Significant association p.Value (0.032) between prevalence of postoperative infection and type of surgery. Conclusion: Perioperative prophylactic antibiotics have been proven to lower infection rates postoperatively. Open reduction presented with significant complication (infection) than closed reduction modality of treatment.

scholarly journals Role of Prophylactic Antibiotics in Open Mesh Inguinal Hernia Repair

2019 ◽  
Vol 13 (2) ◽  
pp. 18-21
Author(s):  
Md Ataur Rahman Siddiqui ◽  
Mohammad Abdul Aleem ◽  
Md Shahinur Rahman ◽  
Farzana Zafreen
Keyword(s):  
Inguinal Hernia ◽  
Hernia Repair ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Hernia Surgery ◽  
Inguinal Hernia Surgery ◽  
Group A ◽  
Group B ◽  
Open Mesh

Introduction: The role of prophylactic antibiotics in open mesh repair of inguinal hernia is still controversial. The dogmatic hernia specialists are always in favour of no use of antibiotic in case of inguinal hernia repair on contrary, many others favour the use of prophylactic antibiotic. Objective: To determine the role of prophylactic antibiotic in case of open mesh inguinal hernia surgery by a prospective randomized study. Materials and Methods: This prospective randomized interventional and observational study was conducted from March to December 2017 at Combined Military Hospital, Chattogram. Total 40 patients selected for open inguinal hernia surgery were grouped as Group-A and Group-B containing 20 in each group on the basis of systematic random sampling. The Group-A and Group-B patients were treated with a single dose of prophylactic antibiotic (1.5gm Cefuroxime) and a similar quantity of normal saline respectively. Data were recorded, compiled, edited and analyzed by SPSS version 23. Results: The mean age of Group-A and B respondents were 53.16±7.76 and 52.39±5.69 years respectively. Mean duration of surgery was 59.76±2.1 and 54.56±18.3 minutes in Group-A and B respectively. Surgical site infection (SSI) was present in 2(10%) cases of Group-A and 5(25%) of Group-B. Though it was little higher in Group-B, the difference was not statistically significant (p>0.05). Staphylococcus was most prevalent in Group-A and multiple organisms in Group-B. Conclusion: Prophylactic antibiotic is not able to significantly decrease the rate of SSI. Journal of Armed Forces Medical College Bangladesh Vol.13(2) 2017: 18-21

scholarly journals Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain

2015 ◽  
Vol 16 (12) ◽  
pp. 939-943 ◽  
Author(s):  
Leena Alsomadi ◽  
Riyad Al Habahbeh
Keyword(s):  
Pain Scale ◽  
Prophylactic Antibiotics ◽  
Post Treatment ◽  
Endodontic Treatment ◽  
Significant Difference ◽  
Group A ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Group B

ABSTRACT Aim To investigate the efficacy of using antibiotics in post endodontic treatment as a method to alleviate post-treatment pain. Materials and methods After completion of endodontic treatment 129 patients were randomly divided into two groups: Group A (65 patients) received Ibuprofen 400 mg one tablet before procedure and one tablet every 8 hours for the first day, then one tablet once indicated by pain. Group B (64 patients) received the same regimen as group A in addition to amoxicillin, clavulanic acid tablets (one tablet before the procedure, and then one tablet twice daily for a total of 3 days). Intensity of pain at 8 hours interval using visual analog scale (VAS) and total number of Ibuprofen tablets used was recorded by patients. Results Peak postoperative pain occurred at 16 hours posttreatment in both groups, there was a significant difference in the pain scale between the two groups in favor for group B over group A (3.8 vs 2.1 respectively). Pain scale was significantly lower in group B at 24, 32, 40, and 48 hours post-treatment with a p-value of < 0.05. The pain scale at 56, 64 and 72 hours were also less in group B, although could not show up as statistical difference. Patients in group A used statistically significant more Ibuprofen than patients in group B (486 vs 402). Conclusion Antibiotic prescription to manage post endodontic treatment pain results in less pain with less consumption of Ibuprofens. Clinical significance Pain management in endodontics is a real challenge, nonsteroidal anti-inflammatory drugs (NSAIDS) are used effectively in many patients to alleviate post endodontic pain. Nonsteroidal anti-inflammatory drugs may have adverse reactions or may be contraindicated. Short-term use of antibiotics to alleviate pain can be of clinical benefits in these patients. How to cite this article Alsomadi L, Al Habahbeh R. Role of Prophylactic Antibiotics in the Management of Postoperative Endodontic Pain. J Contemp Dent Pract 2015;16(12):939-943.

Traumatic Dislocations of the Lesser Toes

1997 ◽  
Vol 18 (7) ◽  
pp. 406-411 ◽  
Author(s):  
Jacques A. Brunet ◽  
Stanislaw Tubin
Keyword(s):  
Retrospective Analysis ◽  
Open Reduction ◽  
Axial Loading ◽  
Associated Injuries ◽  
Recommended Treatment ◽  
Closed Treatment ◽  
Foot Fractures ◽  
Metatarsophalangeal Joints

Traumatic dislocations of lesser metatarsophalangeal joints (DLMTPJ) and lesser interphalangeal joints (DLIPJ) are very uncommon. A retrospective analysis of 31 cases and of the 16 reported cases was conducted to clarify our understanding of the pathomechanics, the role of associated injuries, recommended treatment, and outcome. Hyperextension with axial loading produces the injuries. Ipsilateral foot fractures or dislocations often occur and thus may compromise the outcome. Thirty percent of DLMTPJ and virtually all DLIPJ require open reduction; most often, the plantar plate prevents closed treatment of either DLMTPJ or DLIPJ. At follow-up, treated isolated DLMTPJ have few or no complaints; disability persists in patients who suffered concomitant displaced ipsilateral midfoot or forefoot fractures or dislocations. Neglected DLMTPJ remain symptomatic. All reduced DLIPJ are pain free.

EP.TH.670Antibiotic Prophylaxis Use In Paediatric Robotic-Assisted Laparoscopic Pyeloplasty: A Systematic Review

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Sierra Schaffer ◽  
Parker O'Neill
Keyword(s):  
Systematic Review ◽  
Prophylactic Antibiotic ◽  
Prophylactic Antibiotics ◽  
Current Evidence ◽  
Cochrane Library ◽  
Paediatric Surgery ◽  
Laparoscopic Pyeloplasty ◽  
Postoperative Infections ◽  
Robotic Assisted ◽  
Mesh Terms

Abstract Aim A systematic review was conducted to evaluate the current evidence for prophylactic antibiotic use in paediatric robotic-assisted laparoscopic pyeloplasty (RALP). As pyeloplasties are ‘clean contaminated’ procedures, prophylactic antibiotics are recommended, however, recent evidence suggests that antibiotics may be unnecessary. Prophylactic antibiotics are often either under or over prescribed in paediatric surgery, which increases the risk of developing antibiotic resistance. In general, minimally invasive surgery is associated with less postoperative infections, however, it is not yet clear how RALP compares with other approaches. Recent reviews have indicated prophylactic antibiotics may not decrease postoperative infections, however, there are no clear guidelines. Methods A systematic review was conducted of the following electronic databases: Pubmed, Medline Ovid, The Cochrane Library, TRIP Database, NICE Evidence Search, and EMBASE. The search terms used were: paediatric, pyeloplasty, robotic, antibiotic and were used as keywords as well as in combination as MeSH terms. Results Forty-one articles were retrieved, and after screening for relevance and redundancy, 2 articles remained including a total of 315 pyeloplasties. Prophylactic antibiotics did not reduce the incidence of postoperative UTIs in RALP. Conclusion Prophylactic antibiotics for RALP is not associated with lower rates of UTIs and therefore, may be reserved for patients with risk factors. However, due to the limited data and confounding factors, further research is required to optimise antibiotic stewardship and infection prevention.

Colonoscopy in Automated Peritoneal Dialysis Patients: Value of Prophylactic Antibiotics: A Prospective Study on a Single Antibiotic

2017 ◽  
Vol 40 (10) ◽  
pp. 550-557 ◽  
Author(s):  
Abdullah K. Al-Hwiesh ◽  
Ibrahiem S. Abdul-Rahman ◽  
Mohammad A. Hussameldeen ◽  
Nadia Al-Audah ◽  
Abdalla Abdelrahman ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Peritoneal Dialysis ◽  
Randomized Study ◽  
Multiple Logistic Regression Analysis ◽  
Prophylactic Antibiotic ◽  
Colonic Polyps ◽  
Antibiotic Use ◽  
Prophylactic Antibiotics ◽  
Automated Peritoneal Dialysis ◽  
Group B

Objective To evaluate the need for prophylactic antibiotics in automated peritoneal dialysis (APD) patients undergoing flexible colonoscopy. Patients and Methods A total of 93 patients on automated peritoneal dialysis (APD) undergoing diagnostic colonoscopy were enrolled in a prospective, randomized study. Patients were randomized into 2 age- and sex-matched groups; group A (46 patients) with intraperitoneal (IP) ceftazidime prior to colonoscopy and group B (47 patients) without prophylactic antibiotics. The relations between peritonitis and different parameters were analyzed. Results: Of all colonoscopies, 60.2% showed normal findings, 17.2% with colonic polyps at different sites, 12.9% with angiodysplastic-like lesions, 5.4% with colonic ulcer(s), 3.2% with diverticulae without diverticulitis and 1.1% had transverse colon stricture. Post-colonoscopy peritonitis was documented in 3 (6.5%) and 4 (8.5%) patients in groups A and B, respectively (p = 0.2742); the causative organisms were mainly gram negative bacteria. Polypectomy was not associated with increased peritonitis episodes. By multiple logistic regression analysis, diabetes mellitus was the only independent variable that entered into the best predictive equation over the development of post-colonoscopy peritonitis but not antibiotic use. Conclusions The relation between prophylactic antibiotic use prior to colonoscopy in APD patients and the risk of peritonitis was lacking. Only diabetes mellitus appears to be of significance. Polypectomy did not increase peritonitis episodes.

scholarly journals Is Platelet-Rich Plasma Effective in Enhancing Spinal Fusion? Systematic Overview of Overlapping Meta-Analyses

2021 ◽  
pp. 219256822098827
Author(s):  
Sathish Muthu ◽  
Madhan Jeyaraman ◽  
Parvez Ahmad Ganie ◽  
Manish Khanna
Keyword(s):  
Spinal Fusion ◽  
Platelet Rich Plasma ◽  
Current Evidence ◽  
Eligibility Criteria ◽  
Decision Algorithm ◽  
Fusion Procedure ◽  
Systematic Overview ◽  
Patient Reported ◽  
Meta Analyses

Study Design: Systematic review. Objectives: We performed this systematic overview on overlapping meta-analyses that analyzed the role of platelet-rich plasma(PRP) in enhancing spinal fusion and identify which study provides the current best evidence on the topic and generate recommendations for the same. Materials and Methods: We conducted independent and duplicate electronic database searches in PubMed, Web of Science, Embase, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects till October-2020 for meta-analyses that analyzed the role of PRP in spinal fusion procedures. Methodological quality assessment was made using Oxford Levels of Evidence, AMSTAR scoring, and AMSTAR 2 grades. We then utilized the Jadad decision algorithm to identify the study with highest quality to represent the current best evidence to generate recommendations. Results: 3 meta-analyses fulfilling the eligibility criteria were included. The AMSTAR scores of included studies varied from 5-8(mean:6.3) and all included studies had critically low reliability in their summary of results due to their methodological flaws according to AMSTAR 2 grades. The current best evidence showed that utilization of PRP was not associated with significant improvement in patient-reported outcomes such as Visual Analog Score for pain compared to the standard fusion procedure. Moreover, PRP was found to be associated with lower fusion rates. Conclusion: Based on this systematic overview, the effectiveness of PRP as a biological agent in augmenting spinal fusion is limited. Current evidence does not support the use of PRP as an adjuvant to enhance spinal fusion.

scholarly journals Prophylactic antibiotics in acute pancreatitis: endless debate

2017 ◽  
Vol 99 (2) ◽  
pp. 107-112 ◽  
Author(s):  
MM Mourad ◽  
RPT Evans ◽  
V Kalidindi ◽  
R Navaratnam ◽  
L Dvorkin ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Multiple Organ ◽  
Prophylactic Antibiotics ◽  
Morbidity And Mortality ◽  
Current Evidence ◽  
High Morbidity ◽  
Antibiotic Administration ◽  
Infected Necrosis ◽  
Pancreatic Infection

INTRODUCTION The development of pancreatic infection is associated with the development of a deteriorating disease with subsequent high morbidity and mortality. There is agreement that in mild pancreatitis there is no need to use antibiotics; in severe pancreatitis it would appear to be a logical choice to use antibiotics to prevent secondary pancreatic infection and decrease associated mortality. MATERIALS AND METHODS A non-systematic review of current evidence, meta-analyses and randomized controlled trials was conducted to assess the role of prophylactic antibiotics in acute pancreatitis and whether it might improve morbidity and mortality in pancreatitis. RESULTS Mixed evidence was found to support and refute the role of prophylactic antibiotics in acute pancreatitis. Most studies have failed to demonstrate much benefit from its routine use. Data from our unit suggested little benefit of their routine use, and showed that the mortality of those treated with antibiotics was significantly higher compared with those not treated with antibiotics (9% vs 0%, respectively, P = 0.043). In addition, the antibiotic group had significantly higher morbidity (36% vs 5%, respectively, P = 0.002). CONCLUSIONS Antibiotics should be used in patients who develop sepsis, infected necrosis-related systemic inflammatory response syndrome, multiple organ dysfunction syndrome or pancreatic and extra-pancreatic infection. Despite the many other factors that should be considered, prompt antibiotic therapy is recommended once inflammatory markers are raised, to prevent secondary pancreatic infection. Unfortunately, there remain many unanswered questions regarding the indications for antibiotic administration and the patients who benefit from antibiotic treatment in acute pancreatitis.

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