Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk pati...Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting aspects.High-risk patients are those who are older than 70 years,have diabetes mellitus,whose operation time exceeded 120 minutes,have acute cholecystitis,experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage,suffered from obstructive jaundice,or were deemed immuno-compromised.For gallbladder perforation,one dose of antibiotic prophylaxis is sufficient.Therefore,guidelines are needed and must be strictly followed.Prophy-lactic treatment is not needed for patients at low risk of developing sepsis fo-llowing elective laparoscopic cholecystectomy,although the opposite is suppor-ted.Similarly,superficial surgical infections are related to low morbidity.Patients without risk factors have a very low risk of infection.Thus,the routine use of anti-biotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.展开更多
In this article, we have addressed the recent published article by Wang et al whichexamines risk factors associated with surgical site infections (SSIs) and evaluatesthe effectiveness of prophylactic antibiotics in th...In this article, we have addressed the recent published article by Wang et al whichexamines risk factors associated with surgical site infections (SSIs) and evaluatesthe effectiveness of prophylactic antibiotics in their prevention. Wang et al identifiedseveral significant risk factors of SSIs, including age ≥ 60 years, diabetesmellitus, and surgical complications such as insufficient cystic duct stump closure,gallbladder perforation, empyema, and postoperative hematoma. Their findingssuggest that prophylactic antibiotics can serve as a protective factor against SSIs.However, other reported risk factors and preventive strategies warrant considerationto further reduce the incidence of SSIs, lower healthcare costs, and enhancepatient outcomes. Additionally, the judicious use of prophylactic antibioticsis crucial in light of the growing global challenge of antibiotic resistance caused bythe misuse and overuse of antibiotics. Effective management strategies forprophylactic antibiotic use should be prioritized to balance infection control withthe need to combat antimicrobial resistance.展开更多
BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluat...BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.METHODS A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024.Patients were divided into infected(n=36)and non-infected(n=364)groups based on the occurrence of SSIs.Data collected included age,diabetes mellitus status,use of prophylactic antibiotics,and specific surgical complications.Statistical analyses using SPSS(Version 27.0)involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.RESULTS The use of prophylactic antibiotics significantly reduced the incidence of SSIs(χ²=68.34,P<0.01).Older age(≥60 years)and comorbidities such as diabetes mellitus were identified as significant risk factors.Surgical complications like insufficient cystic duct stump,gallbladder perforation,and empyema also increased SSI risk.Notably,factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.CONCLUSION Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC.Age,diabetes mellitus,and certain surgical complications significantly contribute to the risk.Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.展开更多
AIM: To investigate the role of prophylactic antibiotics in the reduction of mortality of severe acute pancreatitis (SAP) patients, which is highly questioned by more and more randomized controlled trials (RCTs) and m...AIM: To investigate the role of prophylactic antibiotics in the reduction of mortality of severe acute pancreatitis (SAP) patients, which is highly questioned by more and more randomized controlled trials (RCTs) and metaanalyses. METHODS: An updated meta-analysis was performed. RCTs comparing prophylactic antibiotics for SAP with control or placebo were included for meta-analysis. The mortality outcomes were pooled for estimation, and re-pooled estimation was performed by the sensitivity analysis of an ideal large-scale RCT. RESULTS: Currently available 11 RCTs were included. Subgroup analysis showed that there was significant reduction of mortality rate in the period before 2000, while no significant reduction in the period from 2000 [Risk Ratio, (RR ) = 1.01, P = 0.98]. Funnel plot indi-cated that there might be apparent publication bias in the period before 2000. Sensitivity analysis showed that the RR of mortality rate ranged from 0.77 to 1.00 with a relatively narrow confidence interval (P < 0.05). However, the number needed to treat having a minor lower limit of the range (7-5096 patients) implied that certain SAP patients could still potentially prevent death by antibiotic prophylaxis. CONCLUSION: Current evidences do not support prophylactic antibiotics as a routine treatment for SAP, but the potentially benefited sub-population requires further investigations.展开更多
Bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. Antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile ...Bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. Antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile infection (CDI). We argue against the conclusion of the authors and consider that this result may be simply due to concurrent use of metronidazole, a therapeutic agent against CDI.展开更多
BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aime...BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.展开更多
BACKGROUND Delayed sternal closure(DSC)can be a lifesaving approach for certain patients who have undergone cardiac surgery.The value of the type of prophylactic antibiotics in DSC is still debatable.AIM To investigat...BACKGROUND Delayed sternal closure(DSC)can be a lifesaving approach for certain patients who have undergone cardiac surgery.The value of the type of prophylactic antibiotics in DSC is still debatable.AIM To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.METHODS This was a retrospective observational single-center study.Fifty-three consecutive patients who underwent cardiac surgery and had an indication for DSC were included.Patients were subjected to two regimens of antibiotics:Narrow-spectrum and broad-spectrum regimens.RESULTS The main outcome measures were length of hospital and intensive care unit(ICU)stay,duration of mechanical ventilation,and mortality.Of the 53 patients,12(22.6%)received narrow-spectrum antibiotics,and 41(77.4%)received broad-spectrum antibiotics.The mean age was 59.0±12.1 years,without significant differences between the groups.The mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrowspectrum group(11.9±8.7 vs 3.4±2.0 d,P<0.001).The median duration of open chest was 3.0(2.0-5.0)d for all patients,with no difference between groups(P=0.146).The median duration of mechanical ventilation was significantly longer in the broad-spectrum group[60.0(Δinterquartile range(IQR)170.0)h vs 50.0(ΔIQR 113.0)h,P=0.047].Similarly,the median length of stay for both ICU and hospital were significantly longer in the broadspectrum group[7.5(ΔIQR 10.0)d vs 5.0(ΔIQR 5.0)d,P=0.008]and[27.0(ΔIQR 30.0)d vs 19.0(ΔIQR 21.0)d,P=0.031].Five(9.8%)patients were readmitted to the ICU and 18(34.6%)patients died without a difference between groups.CONCLUSION Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration,length of ICU and hospital stays vs narrow-spectrum antibiotics.展开更多
Background:Acute-on-chronic liver failure(ACLF)is characterized by an excessive systemic inflammatory response and organ failure and has high mortality.Bacterial infections(Bis)worsen the clinical course of ACLF and c...Background:Acute-on-chronic liver failure(ACLF)is characterized by an excessive systemic inflammatory response and organ failure and has high mortality.Bacterial infections(Bis)worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients.The efficacy of third-generation cephalosporins has been challenged in recent years.The aim of this study was to characterize the difference between ACLF patients with and without Bis and to provide a reference for medical intervention.展开更多
This research aimed to study whether Enteromorpha polysaccharide-zinc(EP-Zn)can act as an alternative to antibiotics in weaned piglet feeds.Two hundred and twenty-four weaned piglets from 14 pens were randomly assigne...This research aimed to study whether Enteromorpha polysaccharide-zinc(EP-Zn)can act as an alternative to antibiotics in weaned piglet feeds.Two hundred and twenty-four weaned piglets from 14 pens were randomly assigned into 1 of 2 groups according to their body weight and litter size(7 pens/group).The piglets in the antibiotics group were fed with olaquindox at 400 mg/kg and enduracidin at 800 mg/kg basal diet,and piglets in the EP-Zn group were fed with EP-Zn at 800 mg/kg basal diet.One piglet per pen was selected to collect samples after 14 d of feeding.Results showed that EP-Zn supplementation significantly increased the plasma anti-oxidants level compared with the antibiotics group.However,a nonsignificant difference was observed in growth performance between treatment groups.Additionally,the intestinal tight junction(TJ)protein expression and the histopathologic evaluation data showed that EP-Zn contributed to improving intestinal development.Further,piglets in the EP-Zn group had a lower level of intestinal inflammation-related cytokines including IL-6(P<0.001),IL-8(P<0.05),IL-12(P<0.05)and tumor necrosis factor-α(TNF-α)(P<0.001),and showed an inhibition of the phosphor-ylation nuclear transcription factor-kappa B(p-NF-kB)(P<0.05)and total NF-kB(P<0.001)level in the jejunal mucosa.Taken together,it is supposed that EP-Zn,to some extent,would be a potent alternative to prophylactic antibiotics in improving the health status of weaned piglets.展开更多
Objective:To analyze the value of prophylactic antibiotic use in reducing the incidence of pancreatic necrosis in patients with emergency acute pancreatitis(AP).Methods:A total of 70 AP patients who sought medical att...Objective:To analyze the value of prophylactic antibiotic use in reducing the incidence of pancreatic necrosis in patients with emergency acute pancreatitis(AP).Methods:A total of 70 AP patients who sought medical attention from January 2024 to January 2025 were randomly divided into groups by drawing lots.Group A received prophylactic antibiotic intervention,while Group B received conventional intervention.Results:Group A demonstrated superior outcomes compared to Group B in terms of therapeutic efficacy,duration of symptoms,inflammatory factors,symptom scores,and complication rates,with p<0.05.Conclusion:Prophylactic antibiotic treatment in emergency AP patients leads to a decrease in inflammatory factor levels,alleviation of symptoms,a reduction in the incidence of infectious pancreatic necrosis,and is safe and effective.展开更多
Background It is unclear whether the efficacy of single prophylactic antibiotic administration has an impact on infection and death in patients with Aortic Dissection of Stanford B treated by Endovascular Aortic Repa...Background It is unclear whether the efficacy of single prophylactic antibiotic administration has an impact on infection and death in patients with Aortic Dissection of Stanford B treated by Endovascular Aortic Repair （EVAR）. Methods According to whether or not received antibiotics prophylaxis, patients were divided into two groups： the single prophylactic antibiotic group （Group A） and non-prophylactic antibiotic group （Group B）. Procalcitonin （PCT） and other clinical data were obtained with follow-up for one year. Results A total of 201 patients were screened. Among which, 70 patients received single antibiotic administration and 131 patients did not. 31（44.3%） patients had fever in group A while 81（61.8%） patients had fever in group B after EVAR （P=0.017）. The PCT and C-reactive protein （CRP） were significantly different between the two group： 0.18 ± 0.31 vs. 0.76 ± 1.18（ng/mL） （P=0. 000）, 81.35 ± 31.83 vs. 105.02 ± 60.37（mg/mL） （P=0.000）, respectively. By comparison of incidences of postoperative infection, 4（5.7%） patients were infected in Group A while 26（19.8%） patients were infected in Group B （P=0.007）. In infected group, the PCT in group A was 1.04±0.82 while that in Group B was 2.67±1.28 （P=0.015）. In non-infected group, the PCT in group A was 0.12±0.14 while that in Group B was 0.29± 0.44 （P=0.005）. Finally, One-year mortality in group A was 2（2.9%） while that in Group B （P=0.037） was 15 （11.5%）. Conclusion Single prophylactic antibiotic administration can significantly reduce the incidences of postoperative infection and affect the prognosis after EVAR.展开更多
Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide h...Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.展开更多
AIM:To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is safe in patients with ventriculoperitoneal (VP) shunts.METHODS: This was a retrospective study of all patients undergoing PEG inse...AIM:To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is safe in patients with ventriculoperitoneal (VP) shunts.METHODS: This was a retrospective study of all patients undergoing PEG insertion at our institution between June 1999 and June 2006. Post-PEG complications were compared between two groups according to the presence or absence of VP shunts. VP shunt infection rates, the interval between PEG placement and VP shunt catheter insertion, and long-term follow-up were also investigated.RESULTS: Fifty-five patients qualified for the study. Seven patients (12.7%) had pre-existing VP shunts. All patients received prophylactic antibiotics. The complication rate did not differ between VP shunt patients undergoing PEG (PEG/VP group) and non-VP shunt patients undergoing PEG (control group) [1 (14.3%) vs 6 (12.5%), P=1.000]. All patients in the PEG/VP group had undergone VP shunt insertion prior to PEG placement. The mean interval between VP shunt insertion and PEG placement was 308.7 d (range, 65-831 d). The mean follow-up duration in the PEG/VP group was 6.4 mo (range, 1-15 mo). There were no VP shunt infections, although one patient in the PEG/VP group developed a minor peristomal infection during follow-up.CONCLUSION: Complications following PEG placement in patients with VP shunts were infrequent in this study.展开更多
文摘Inappropriate use of antibiotics leads to microbial resistance.Single-dose antibio-tic prophylaxis prior to laparoscopic cholecystectomy is well known for reducing the risk of postoperative infection in high-risk patients despite some conflicting aspects.High-risk patients are those who are older than 70 years,have diabetes mellitus,whose operation time exceeded 120 minutes,have acute cholecystitis,experienced iatrogenic intraoperative gallbladder perforation resulting in bile or gallstone spillage,suffered from obstructive jaundice,or were deemed immuno-compromised.For gallbladder perforation,one dose of antibiotic prophylaxis is sufficient.Therefore,guidelines are needed and must be strictly followed.Prophy-lactic treatment is not needed for patients at low risk of developing sepsis fo-llowing elective laparoscopic cholecystectomy,although the opposite is suppor-ted.Similarly,superficial surgical infections are related to low morbidity.Patients without risk factors have a very low risk of infection.Thus,the routine use of anti-biotic prophylaxis in elective laparoscopic cholecystectomy is not recommended.
基金Supported by Scientific Research Foundation of Shanghai Municipal Health Commission of Changning District,No.20234Y038Medical Science and Technology Research Foundation of Guangdong Province,China,No.C2022023.
文摘In this article, we have addressed the recent published article by Wang et al whichexamines risk factors associated with surgical site infections (SSIs) and evaluatesthe effectiveness of prophylactic antibiotics in their prevention. Wang et al identifiedseveral significant risk factors of SSIs, including age ≥ 60 years, diabetesmellitus, and surgical complications such as insufficient cystic duct stump closure,gallbladder perforation, empyema, and postoperative hematoma. Their findingssuggest that prophylactic antibiotics can serve as a protective factor against SSIs.However, other reported risk factors and preventive strategies warrant considerationto further reduce the incidence of SSIs, lower healthcare costs, and enhancepatient outcomes. Additionally, the judicious use of prophylactic antibioticsis crucial in light of the growing global challenge of antibiotic resistance caused bythe misuse and overuse of antibiotics. Effective management strategies forprophylactic antibiotic use should be prioritized to balance infection control withthe need to combat antimicrobial resistance.
文摘BACKGROUND Surgical site infections(SSIs)are a significant complication in laparoscopic cholecystectomy(LC),affecting patient outcomes and healthcare costs.AIM To identify risk factors associated with SSIs and evaluate the effectiveness of prophylactic antibiotics in reducing these infections.METHODS A comprehensive retrospective evaluation was conducted on 400 patients who underwent LC from January 2022 to January 2024.Patients were divided into infected(n=36)and non-infected(n=364)groups based on the occurrence of SSIs.Data collected included age,diabetes mellitus status,use of prophylactic antibiotics,and specific surgical complications.Statistical analyses using SPSS(Version 27.0)involved univariate and multivariate logistic regression to determine factors influencing the risk of SSIs.RESULTS The use of prophylactic antibiotics significantly reduced the incidence of SSIs(χ²=68.34,P<0.01).Older age(≥60 years)and comorbidities such as diabetes mellitus were identified as significant risk factors.Surgical complications like insufficient cystic duct stump,gallbladder perforation,and empyema also increased SSI risk.Notably,factors such as intraoperative blood loss and operation time did not significantly impact SSI occurrence.CONCLUSION Prophylactic antibiotics are effective in reducing the risk of SSIs in patients undergoing LC.Age,diabetes mellitus,and certain surgical complications significantly contribute to the risk.Effective management of these risk factors is essential to improve surgical outcomes and reduce the incidence of SSIs.
基金Supported by The National Natural Science Foundation of China,No. 81072910
文摘AIM: To investigate the role of prophylactic antibiotics in the reduction of mortality of severe acute pancreatitis (SAP) patients, which is highly questioned by more and more randomized controlled trials (RCTs) and metaanalyses. METHODS: An updated meta-analysis was performed. RCTs comparing prophylactic antibiotics for SAP with control or placebo were included for meta-analysis. The mortality outcomes were pooled for estimation, and re-pooled estimation was performed by the sensitivity analysis of an ideal large-scale RCT. RESULTS: Currently available 11 RCTs were included. Subgroup analysis showed that there was significant reduction of mortality rate in the period before 2000, while no significant reduction in the period from 2000 [Risk Ratio, (RR ) = 1.01, P = 0.98]. Funnel plot indi-cated that there might be apparent publication bias in the period before 2000. Sensitivity analysis showed that the RR of mortality rate ranged from 0.77 to 1.00 with a relatively narrow confidence interval (P < 0.05). However, the number needed to treat having a minor lower limit of the range (7-5096 patients) implied that certain SAP patients could still potentially prevent death by antibiotic prophylaxis. CONCLUSION: Current evidences do not support prophylactic antibiotics as a routine treatment for SAP, but the potentially benefited sub-population requires further investigations.
文摘Bron et al presented a retrospective study regarding the prophylactic use of antibiotics for variceal hemorrhage. Antibiotics appeared to improve the survival rate of patients without increasing clostridium difficile infection (CDI). We argue against the conclusion of the authors and consider that this result may be simply due to concurrent use of metronidazole, a therapeutic agent against CDI.
文摘BACKGROUND: Currently, prophylactic antibiotics are recommended only for cirrhotic patients with acute upper gastrointestinal bleeding(AUGIB);however, the benefit for other AUGIB patients remains undetermined. We aimed to compare the clinical outcomes between patients with AUGIB with and without prophylactic antibiotics to identify the population that requires this therapy.METHODS: Patients with AUGIB admitted between 1st January 2019 and 31st December 2021 in the Emergency Department of Peking Union Medical College Hospital were enrolled. Patients were divided into the antibiotic and non-antibiotic groups. The primary outcome was in-hospital mortality, and the secondary outcome was the onset of new infection. The risk factors for mortality and infection were analyzed, and stratification analysis of prophylactic antibiotics was performed. Continuous data were analyzed using the t-test or nonparametric rank sum test, and categorical data were analyzed using the Chi-square test or Fisher's exact test. Indicators with significant differences between the groups were included for logistic regression analysis. A P-value <0.05 was considered statistically significant. RESULTS: A total of 392 individuals were included, among them, 281 patients received prophylactic antibiotics, and 111 patients did not receive prophylactic antibiotics. The mortality rates were significantly lower in the antibiotic group than in the non-antibiotics group(6.41% vs. 17.12%, P=0.001). The risk factors for infection were varicose veins(P=0.045) and endotracheal intubation(P=0.005) in the prophylactic antibiotic group, and endoscopic treatment(P=0.010) in the non-prophylactic antibiotic group. Stratified analyses showed that patients with age ≥ 65 years, endotracheal intubation, endoscopic treatment, and AUGIB of variceal etiologies benefited from prophylactic antibiotics.CONCLUSION: AUGIB patients may benefit from prophylactic antibiotics to decrease mortality, especially those aged ≥ 65 years and those with endotracheal intubation, endoscopic treatment, and variceal etiologies.
文摘BACKGROUND Delayed sternal closure(DSC)can be a lifesaving approach for certain patients who have undergone cardiac surgery.The value of the type of prophylactic antibiotics in DSC is still debatable.AIM To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac surgery.METHODS This was a retrospective observational single-center study.Fifty-three consecutive patients who underwent cardiac surgery and had an indication for DSC were included.Patients were subjected to two regimens of antibiotics:Narrow-spectrum and broad-spectrum regimens.RESULTS The main outcome measures were length of hospital and intensive care unit(ICU)stay,duration of mechanical ventilation,and mortality.Of the 53 patients,12(22.6%)received narrow-spectrum antibiotics,and 41(77.4%)received broad-spectrum antibiotics.The mean age was 59.0±12.1 years,without significant differences between the groups.The mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrowspectrum group(11.9±8.7 vs 3.4±2.0 d,P<0.001).The median duration of open chest was 3.0(2.0-5.0)d for all patients,with no difference between groups(P=0.146).The median duration of mechanical ventilation was significantly longer in the broad-spectrum group[60.0(Δinterquartile range(IQR)170.0)h vs 50.0(ΔIQR 113.0)h,P=0.047].Similarly,the median length of stay for both ICU and hospital were significantly longer in the broadspectrum group[7.5(ΔIQR 10.0)d vs 5.0(ΔIQR 5.0)d,P=0.008]and[27.0(ΔIQR 30.0)d vs 19.0(ΔIQR 21.0)d,P=0.031].Five(9.8%)patients were readmitted to the ICU and 18(34.6%)patients died without a difference between groups.CONCLUSION Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration,length of ICU and hospital stays vs narrow-spectrum antibiotics.
文摘Background:Acute-on-chronic liver failure(ACLF)is characterized by an excessive systemic inflammatory response and organ failure and has high mortality.Bacterial infections(Bis)worsen the clinical course of ACLF and carry a poor prognosis in ACLF patients.The efficacy of third-generation cephalosporins has been challenged in recent years.The aim of this study was to characterize the difference between ACLF patients with and without Bis and to provide a reference for medical intervention.
基金supported by grants from the NSFC(31902196)China Postdoctoral Science Foundation funded project(2019M662273)+2 种基金Jiangxi Provincial Innovation and Entrepreneurship projectsTaishan industry leading talent blue talent projectHunan Provincial Natural Science Foundation of China(2019JJ50268)
文摘This research aimed to study whether Enteromorpha polysaccharide-zinc(EP-Zn)can act as an alternative to antibiotics in weaned piglet feeds.Two hundred and twenty-four weaned piglets from 14 pens were randomly assigned into 1 of 2 groups according to their body weight and litter size(7 pens/group).The piglets in the antibiotics group were fed with olaquindox at 400 mg/kg and enduracidin at 800 mg/kg basal diet,and piglets in the EP-Zn group were fed with EP-Zn at 800 mg/kg basal diet.One piglet per pen was selected to collect samples after 14 d of feeding.Results showed that EP-Zn supplementation significantly increased the plasma anti-oxidants level compared with the antibiotics group.However,a nonsignificant difference was observed in growth performance between treatment groups.Additionally,the intestinal tight junction(TJ)protein expression and the histopathologic evaluation data showed that EP-Zn contributed to improving intestinal development.Further,piglets in the EP-Zn group had a lower level of intestinal inflammation-related cytokines including IL-6(P<0.001),IL-8(P<0.05),IL-12(P<0.05)and tumor necrosis factor-α(TNF-α)(P<0.001),and showed an inhibition of the phosphor-ylation nuclear transcription factor-kappa B(p-NF-kB)(P<0.05)and total NF-kB(P<0.001)level in the jejunal mucosa.Taken together,it is supposed that EP-Zn,to some extent,would be a potent alternative to prophylactic antibiotics in improving the health status of weaned piglets.
文摘Objective:To analyze the value of prophylactic antibiotic use in reducing the incidence of pancreatic necrosis in patients with emergency acute pancreatitis(AP).Methods:A total of 70 AP patients who sought medical attention from January 2024 to January 2025 were randomly divided into groups by drawing lots.Group A received prophylactic antibiotic intervention,while Group B received conventional intervention.Results:Group A demonstrated superior outcomes compared to Group B in terms of therapeutic efficacy,duration of symptoms,inflammatory factors,symptom scores,and complication rates,with p<0.05.Conclusion:Prophylactic antibiotic treatment in emergency AP patients leads to a decrease in inflammatory factor levels,alleviation of symptoms,a reduction in the incidence of infectious pancreatic necrosis,and is safe and effective.
基金supported by Medical Research Foundation of Guangdong Province(No.A2014060)Medical Research Foundation of Kashgar(No.2015Y02)Technology Project of Kashgar region's first people's hospital(No.105)
文摘Background It is unclear whether the efficacy of single prophylactic antibiotic administration has an impact on infection and death in patients with Aortic Dissection of Stanford B treated by Endovascular Aortic Repair （EVAR）. Methods According to whether or not received antibiotics prophylaxis, patients were divided into two groups： the single prophylactic antibiotic group （Group A） and non-prophylactic antibiotic group （Group B）. Procalcitonin （PCT） and other clinical data were obtained with follow-up for one year. Results A total of 201 patients were screened. Among which, 70 patients received single antibiotic administration and 131 patients did not. 31（44.3%） patients had fever in group A while 81（61.8%） patients had fever in group B after EVAR （P=0.017）. The PCT and C-reactive protein （CRP） were significantly different between the two group： 0.18 ± 0.31 vs. 0.76 ± 1.18（ng/mL） （P=0. 000）, 81.35 ± 31.83 vs. 105.02 ± 60.37（mg/mL） （P=0.000）, respectively. By comparison of incidences of postoperative infection, 4（5.7%） patients were infected in Group A while 26（19.8%） patients were infected in Group B （P=0.007）. In infected group, the PCT in group A was 1.04±0.82 while that in Group B was 2.67±1.28 （P=0.015）. In non-infected group, the PCT in group A was 0.12±0.14 while that in Group B was 0.29± 0.44 （P=0.005）. Finally, One-year mortality in group A was 2（2.9%） while that in Group B （P=0.037） was 15 （11.5%）. Conclusion Single prophylactic antibiotic administration can significantly reduce the incidences of postoperative infection and affect the prognosis after EVAR.
文摘Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.
文摘AIM:To investigate whether percutaneous endoscopic gastrostomy (PEG) tube placement is safe in patients with ventriculoperitoneal (VP) shunts.METHODS: This was a retrospective study of all patients undergoing PEG insertion at our institution between June 1999 and June 2006. Post-PEG complications were compared between two groups according to the presence or absence of VP shunts. VP shunt infection rates, the interval between PEG placement and VP shunt catheter insertion, and long-term follow-up were also investigated.RESULTS: Fifty-five patients qualified for the study. Seven patients (12.7%) had pre-existing VP shunts. All patients received prophylactic antibiotics. The complication rate did not differ between VP shunt patients undergoing PEG (PEG/VP group) and non-VP shunt patients undergoing PEG (control group) [1 (14.3%) vs 6 (12.5%), P=1.000]. All patients in the PEG/VP group had undergone VP shunt insertion prior to PEG placement. The mean interval between VP shunt insertion and PEG placement was 308.7 d (range, 65-831 d). The mean follow-up duration in the PEG/VP group was 6.4 mo (range, 1-15 mo). There were no VP shunt infections, although one patient in the PEG/VP group developed a minor peristomal infection during follow-up.CONCLUSION: Complications following PEG placement in patients with VP shunts were infrequent in this study.
