scholarly journals Single vs Multiple Dose of Cefazolin Prophylaxis in Elective Cesarean Section

2017 ◽  
pp. 60
Author(s):  
Sigit Purbadi ◽  
Muhamad Fadli
Keyword(s):  
Single Dose ◽  
Multiple Dose ◽  
Obstet Gynecol ◽  
Prophylactic Antibiotic ◽  
Clinical Findings ◽  
Elective Cesarean Section ◽  
Maternal Infection ◽  
Elective Cesarean ◽  
Single Blind

Introduction: Caesarean section (CS) is one of port d’ entrée from infection in women and it is related to maternal morbidity during puerpureal period. Until now, there is still lack of consensus regarding prophylactic antibiotic protocol before CS procedure. This study aims to determine the comparative efficacy between single dose and multiple doses of cefazolin prior incision toward the incidence of maternal infection. Methods: This was a single-blind, randomized, clinical trial study with two methods of intervention including 2-gram single dose cefazolin at 30 minutes’ prior incision and 2-gram single dose cefazolin at 30 minutes’ prior incision continued 1-gram cefazolin after 8 hours of procedure. We recruited women undergone elective CS at Fatmawati and Anna Hospital, Jakarta from January to March 2016. The primary outcomes were surgical site infection, urinary tract infection, and endometritis based on clinical findings during 30 days of follow-up period. Results: A total of 46 subjects were recruited which 23 of them were in single dose cefazolin group and the other 23 subjects were in multiple dose of cefazolin group. There were 9 subjects having infection (19.6%). There was no statistical difference in the incidence of infection between two groups (p=1.00; relative risk 0.80, 95% CI 0.25-2.61). Conclusion: Single dose of cefazolin shows similar rates of infection incidence to multiple dose. Therefore, single dose of cefazolin can be a protocol in CS based on its efficacy and efficiency. [Indones J Obstet Gynecol 2017; 5-1: 60-65] Keywords: cefazolin, maternal infection, multipe dose, single dose

Acute Dystonia after a Single Dose of Intravenous Metoclopramide during Elective Cesarean Section: A Case Report.

2019 ◽  
Vol 8 (1) ◽  
Author(s):  
Danielle Levin
Keyword(s):  
Single Dose ◽  
Case Report ◽  
Cesarean Section ◽  
Epidural Anesthesia ◽  
Elective Cesarean Section ◽  
Single Administration ◽  
Dystonic Reaction ◽  
Elective Cesarean ◽  
Combined Spinal Epidural Anesthesia ◽  
Spinal Epidural

We would like to present the first report of severe acute dystonic reaction after a single administration of metoclopramide during cesarean section under combined spinal-epidural anesthesia.  During elective cesarean section, a 30-year-old female vomited four times and was treated with 10mg intravenous metoclopramide and 8mg intravenous ondansetron.  Nausea subsided with the antiemetic treatment, but two minutes later, patient had rapid eye blinking, uncontrollable head movement, and became unresponsive.  Bolus of 50mg intravenous diphenhydramine resolved the acute dystonic symptoms within seconds.  Patient was again oriented times three, with no recollection of symptoms, and remained symptom free for the rest of admission. 

Mixed brain abscess due to Streptococcus and Tuberculosis in a pregnant woman with favorable evolution. A case report

2020 ◽  
pp. 1-3
Keyword(s):  
Brain Abscess ◽  
Public Health Problem ◽  
Elective Cesarean Section ◽  
Histopathological Study ◽  
Global Public Health ◽  
Mother And Child ◽  
Elective Cesarean ◽  
Causes Of Mortality ◽  
Abscess Wall

Tuberculosis is a global public health problem and is among the top ten causes of mortality in the world. We present the unusual case of a 37-year-old woman, referred for fever, progressive headache, nausea, vomiting and change in mental status. Brain imaging studies. showed a left frontal brain abscess with subfalcin herniation. As an urgent procedure, surgical drainage of the brain abscess was performed, and in the culture of pus there was growth of an anaerobic Streptococcus. The histopathological study of the abscess wall showed data on tuberculosis. The patient was pregnant at surgery, for about five weeks and received anti-tuberculous medications with close maternal fetal follow-up. Pregnancy came to term and was resolved by an elective cesarean section, both mother and child had a favorable evolution.

Single-dose antibiotic prophylaxis compared with multiple-dose protocol in clean pediatric neurosurgical interventions: a nonrandomized, historically controlled equivalence trial

2021 ◽  
pp. 1-8
Author(s):  
Esmaeil Mohammadi ◽  
Sina Azadnajafabad ◽  
Mehrdad Goudarzi ◽  
Keyvan Tayebi Meybodi ◽  
Farideh Nejat ◽  
...  
Keyword(s):  
Single Dose ◽  
Multiple Dose ◽  
Antimicrobial Prophylaxis ◽  
Meta Analysis ◽  
Prophylactic Antibiotic ◽  
Surgical Site Infections ◽  
Pediatric Neurosurgery ◽  
Total Cohort ◽  
Neurosurgical Patients ◽  
Tertiary Center

OBJECTIVE Guidelines recommend antimicrobial prophylaxis (AMP) preoperatively for "clean" spinal and cranial surgeries, while dose and timing remain controversial. The use of multiple-dose AMP for such surgeries is under debate in the pediatric context. In this clinical study, the authors aimed to compare single-dose with multiple-dose prophylactic antibiotic usage in cranial and spinal neurosurgical interventions of pediatric patients. METHODS All neurosurgical patients aged 28 days to 18 years who underwent surgery at a single tertiary center were assessed. Three cohorts (noninstrumented clean spinal, noninstrumented cranial, and instrumented cranial interventions), each of which comprised two 50-patient arms (i.e., single-dose AMP and multiple-dose AMP), were included after propensity score–matched retrospective sampling and power analysis. Records were examined for surgical site infections. Using a previously published meta-analysis as the prior and 80% acceptance of equivalence (margin of OR 0.88–1.13), logistic regression was carried out for the total cohort and each subcohort and adjusted for etiology by consideration of multiple-dose AMP as reference. RESULTS The overall sample included 300 age- and sex-matched patients who were evenly distributed in 3 bi-arm cohorts. There was no statistical intercohort difference based on etiology or type of operation (p < 0.05). Equivalence analysis revealed nondiscriminating results for the total cohort (adjusted OR 0.65, 95% CI 0.27–1.57) and each of the subcohorts (noninstrumented clean spinal, adjusted OR 0.65, 95% CI 0.12–3.44; noninstrumented cranial, adjusted OR 0.52, 95% CI 0.14–2.73; and instrumented cranial, adjusted OR 0.68, 95% CI 0.13–3.31). CONCLUSIONS No significant benefit for multiple-dose compared with single-dose AMPs in any of the pediatric neurosurgery settings could be detected. Since unnecessary antibiotic use should be avoided as much as possible, it seems that usage of single-dose AMP is indicated.

Efficacy of a Single Dose versus a Multiple Dose Regimen of Mebendazole against Hookworm Infections among School Children: a Randomized Open-label Trial

2020 ◽  
Author(s):  
Tegegne Eshetu ◽  
Mulugeta Aemero ◽  
Ayalew Jejaw
Keyword(s):  
Single Dose ◽  
Dose Regimen ◽  
Multiple Dose ◽  
Open Label ◽  
Preventive Chemotherapy ◽  
Dose Treatment ◽  
School Aged Children ◽  
Multiple Dose Regimen ◽  
Hookworm Infections

Abstract Background: Despite the existence of a population-based control program using single dose albendazole or mebendazole as a preventive chemotherapy, hookworm transmission remains high. It causes a negative impact on the growth and school performance of children. In connection to this preventive chemotherapy, different studies produced conflicting results. This study aimed at evaluating the efficacy of single (500mg) versus multiple doses (100mg twice a day during three consecutive days) of mebendazole against hookworm infections among school-aged children. Methods: This randomized open-label clinical trial took place among school-aged children (6-14 years old) in Burie and Debre Elias towns, Northwest Ethiopia. Using simple randomization, eligible hookworm-positive children were allocated (1:1) to either a single or multiple dose treatment arms. Stool samples were collected and processed using McMaster method at baseline and follow-up period (14-21 days after treatment). Only laboratory technicians were blinded. The cure and egg reduction rates which were assessed after 14-21 days of treatment were the primary and secondary therapeutic outcome measures against hookworm infections, respectively. An independent t-test was used to compare group means, and logistic regression was used to calculate odds ratio (OR). P-value < 0.05 at 95% CI was considered statistically significant. Result: 108 children, 54 in each treatment arm had completed baseline data and received allocated treatment. 103 children had completed follow-up data records and included for the final efficacy analysis. Cure rate against hookworm was significantly higher in the multiple dose (96.1%) than in the single dose (30.8%) with OR=55.125; 95% CI: 11.92-254.9; P < 0.001. The egg reduction rate in the multiple dose treatment arm (99.5%) was also significantly higher than in the single dose arm (68.9%) with difference t (101) =5.38; 95% CI 230.95-505.36; P < 0.001. Conclusion: The single dose regimen of mebendazole for the treatment of hookworm infections showed poor cure and egg reduction rates, while the multiple dose revealed satisfactory. Although multiple dose regimen administration is a bit more complex than the single dose, we strongly encourage replacing it with multiple dose regimen during deworming programs in hookworm endemic areas. Trial registration: This trial is registered in www.pactr.org, # PACTR201911466695052.

Follow-Up of Growth-Retarded Children Born by Elective Cesarean Section before 33 Weeks

1985 ◽  
Vol 19 (4) ◽  
pp. 169-173 ◽  
Author(s):  
H.J. Huisjes ◽  
R. Baarsma ◽  
M. Hadders-Algra ◽  
B.C.L. Touwen
Keyword(s):  
Cesarean Section ◽  
Elective Cesarean Section ◽  
Elective Cesarean

A Comparative Study of Single Dose and Multiple Dose Antibiotic Prophylaxis In Caesarean Section

2021 ◽  
Vol 8 (3) ◽  
pp. 89-93
Author(s):  
Dr. Poorvi Agarwal ◽  
Dr. Harshal Nimbannavar ◽  
Dr. Prajakta Khose ◽  
Dr. Supraja Subramanian ◽  
Dr. Himadri Bal
Keyword(s):  
Single Dose ◽  
Caesarean Section ◽  
Antibiotic Prophylaxis ◽  
Multiple Dose ◽  
Prophylactic Antibiotic ◽  
Dose Schedule ◽  
Antibiotic Use ◽  
Skin Incision ◽  
Significant Difference ◽  
Group B

Background: Rampant antibiotic use brought about its own set of problems like the rise in incidence of antibiotic resistant strains, allergies and other complications of antibiotic use. Unfortunately in many of our set ups we are still stuck in prolonged post-operative antibiotic regimes. This study aims to fill that lacunae and thereby aid our gradual shift away from over reliance on prolonged antibiotic usage in prevention of SSI. Hence we decided to investigate the efficacy of the use of a single prophylactic intravenous dose of antibiotic vis a vis multiple doses in reducing post-operative infective morbidity in caesarean sections. Methods: The study included 200 patients at term, satisfying the inclusion and exclusion criteria, reporting to the labour room and undergoing caesarean section. The patients were then divided into two groups of 100 each by simple randomization. Patients in Group A were given a single dose of Inj. Cefotaxime 1gm IV + Inj. Metronidazole 500 mg IV infusion 30 minutes before the skin incision. Group B cases were given the first dose of Inj. cefotaxime 1g IV + Inj. metronidazole 500 mg IV 30 minutes before the skin incision followed by injectables for 2 days: Inj. cefotaxime 1g IV BD and Inj. metronidazole 500mg IV TDS. Subsequently for the next 3 days Tablet Cefixime 200mg BD and Tablet Metronidazole 400mg TDS were administered orally. Results:  The present study did not show any significant difference in the post operative infection incidence between the single dose and multiple dose schedule. Conclusion: our study makes an important observation regarding use of antibiotic prophylaxis and its duration for prevention of post operative infections in mothers without compromising any safety aspects of either the mother or the child.  As noted in our study, there was no difference in the outcome as regards post operative infectious morbidity in patients of both the groups. Hence, based on the findings of our study we conclude that single dose prophylactic antibiotic should be the norm for caesarean sections.

scholarly journals Comparison of Short Vs. Long Half-Life Single-Dose Prophylactic Antibiotics for Cesarean Section

1994 ◽  
Vol 2 (3) ◽  
pp. 120-125 ◽  
Author(s):  
Bernard Gonik ◽  
James McGregor
Keyword(s):  
Single Dose ◽  
Cesarean Section ◽  
Half Life ◽  
Study Groups ◽  
Elective Cesarean Section ◽  
Double Blind ◽  
Prophylactic Efficacy ◽  
Cord Clamping ◽  
Containment Measures ◽  
Elective Cesarean

Objective:Numerous studies demonstrate the efficacy of antibiotic prophylaxis for reducing postcesarean section infectious morbidity. The duration of therapy, however, remains controversial. Cost containment measures and the ease of single dosing have led to the introduction of “extended” half-life agents for cesarean-section chemoprophylaxis. We tested the hypothesis that there was no difference in efficacy between a single dose of a short half-life agent (cefoxitin) and a longer half-life agent (cefotetan).Methods:A prospective, double-blind trial of 375 non-elective cesarean-section cases was carried out. Study antibiotics (2 g) were administered intravenously (IV) at cord clamping only.Results:Demographic and clinical variables between the 2 study groups were similar. No significant differences were noted in major or minor morbidity or in infectious morbidities for patients receiving the 2 prophylactic regimens. The occurrence of postoperative endometritis was likewise similar for the subjects receiving cefoxitin (10%) and cefotetan (15%). When cases whose surgery lasted >60 min were evaluated separately, no differences in outcomes between the 2 groups were identifiedConclusions:These findings confirm our hypothesis that the half-life difference between these 2 agents does not impact on single-dose Prophylactic efficacy in cesarean section.

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