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Profilassi antimicrobica della infezione chirurgica in ortopedia. Risultati della indagine epidemiologica promossa per l’Italia dal Journal of Chemotherapy
No full textDoes surgical prophylaxis with teicoplanin constitute a therapeutic advance?
No full textAntibiotic prophylaxis has become standard care not only in operations characterized by high infection rates but also in the vast majority of clean surgical procedures, including those that use foreign materials, grafts or prosthetic devices as well as non-implant surgery. While use of antibiotics in clean implant surgery is undisputed, it is still controversial in clean non-implant surgery. As antibiotic prophylaxis should be directed against expected pathogens, the glycopeptides are considered suitable alternative antibiotics to first and second generation cephalosporins in clean surgical procedures associated with a high risk of wound infections due to Gram-positive bacteria, including methicillin-resistant, and for patients allergic to beta-lactam antibiotics. In deciding whether to use a glycopeptide for prophylaxis, the current wound infection rates with methicillin-resistant Staphylococcus aureus and methicillin-resistant Staphylococcus epidermidis at single institutions need to be considered, to limit the use of glycopeptides to wards where the incidence of methicillin resistance is high. Of the two available glycopeptides, teicoplanin may be preferable to vancomycin for peri-operative prophylaxis because of its excellent tissue penetration, as indicated by the large volume of distribution, lower toxicity, and particularly long half-life, allowing single-dose administration in several surgical procedures. Clinical trials with teicoplanin prophylaxis in several types of clean surgical procedures including orthopedic, cardiac, vascular and dental operations, have shown it to be efficacious. This review focuses on results from clinical studies with this glycopeptide as prophylaxis in clean surgery
Cefetamet pivoxil (CP) and faecal flora: in vitro effects
No full textThe interaction between cefetamet-pivoxil and faecal content was studied in order to define the intestinal impact on unabsorbrd antibiotic. The cefetamet-pvoxil antimicrobial activity was reduced by sterile faeces and this result became more evident in presence of bacterial flora. Cefetamet pivoxil inhibited enterobacteria and enterococci. The unabsorbed eftamet-pivoxil in the gut may have limited effect on the intestinal bacteria ecosyste
Methicillin-resistant staphylococci in clean surgery. Is there a role for prophylaxis?
No full textThe incidence of infection in clean surgery (i.e. surgery with no major contamination of the operative site) should be less than 2%, although the incidence of postoperative infections can be higher in patients with various risk factors (namely insertion of foreign bodies, a compromised immune status or prolonged duration of surgery). Although antibiotic prophylaxis has been shown to reduce the incidence of postoperative infections in clean surgery, there is still no consensus regarding its use in this area. However, for clean surgical procedures that involve implantation of foreign material, grafts or prosthetic devices, prophylaxis is well accepted and justifiable, since this practice is indicated when the benefits exceed the expected risks. Staphylococcus aureus and coagulase-negative staphylococci are responsible for 70 to 90% of wound infections in this type of surgery. First and second generation cephalosporins are considered the drugs of choice for surgical prophylaxis. Cefazolin and other cephalosporins have good tissue penetration but poor coverage against methicillin-resistant staphylococci. The frequency with which methicillin-resistant staphylococci have been recovered in nosocomial infections has increased steadily during recent years. This provides a rationale for the use of alternative antibiotics, such as the glycopeptides (vancomycin and teicoplanin), for prophylaxis in clean surgery in hospitals where the prevalence of methicillin-resistant staphylococci is high. The effectiveness and tolerability of teicoplanin as prophylaxis for orthopaedic surgery involving joint replacement were analysed in 4 randomised controlled trials. Two compared teicoplanin with cefamandole, while the others compared teicoplanin with either cefuroxime or cefazolin. The overall early wound infection rates (within 3 months) in these studies were 1.1% for teicoplanin and 1.7% for the comparator cephalosporin. The overall late infection rate was 0.2% for both treatment groups. Adverse events were attributed to the drug in 1% of patients in both treatment groups. Therefore, on the basis of these trials, single dose teicoplanin is as efficacious and as well tolerated as multiple dose cephalosporin regimens for prophylaxis in prosthetic joint surgery
Valutazione comparativa di due Cefalosporine metossiminiche, Ceftriassone e Cefotassima, in chemioprofilassi antimicrobica nella chirurgia otorino-laringoiatrica: 1° studio multicentrico prospettico e randomizzato.
No full textCEFOSSITINA IN DOSE MULTIPLA VERSUS CEFOTETAN IN DOSE SINGOLA COME CHEMIOPROFILASSI ANTIMICROBICA IN CHIRURGIA COLO RETTALE: RISULTATI DI UNO STUDIO CONTROLLATO MULTICENTRICO
No full textConsiderazioni sulla chemioprofilassi antimicrobica a breve termine in chirurgia ortopedica
No full textEffects on intestinal microflora during systemic perioperative antimicrobial prophylaxis in orthopaedic patients: Teicoplanin (TC) vs Cefazolin (CZ).
No full textalterazioni della flora batterica intestinale in corso di profilassi perioperatoria in pazienti ortopedici si dimostrano selettive in accordo allo spettro d'azione e di modesta entita
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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