 |
|
Single dose of antibiotics before surgery sufficient to help prevent infection
November 21, 2006A single dose of antibiotics prior to surgery appears to prevent infections occurring at the surgical site as effectively as a 24-hour dosing regimen, and with reduced antibiotic costs, according to an article in the November issue of Archives of Surgery, one of the JAMA/Archives journals.
Infections remain an important complication of surgical procedures despite increased knowledge about prevention and technological advances in modern surgery, according to background information in the article. Prophylactic antibiotics-preventive antibiotics given before surgery-have been shown to decrease the occurrence of infection at the site of the surgery. However, due to rising health care costs and concerns about antimicrobial resistance, hospitals have been under pressure to use fewer antibiotics. Most guidelines for the use of prophylactic antibiotics recommend using only one dose prior to surgery; however, surgeons might not comply with this recommendation, sometimes giving patients more than one dose or using broad-spectrum (targeting many types of bacteria) rather than the recommended narrow-spectrum drugs.
Silvia Nunes Szente Fonseca, M.D., M.P.H., Hospital São Francisco, Ribeirão Preto, São Paolo, Brazil, and colleagues studied infection rates before and after the implementation of a one-dose prophylactic antibiotic protocol at a local hospital. "We previously described the successful implementation of an antibiotic prophylaxis program in our hospital, discontinuing prophylactic antibiotic usage after 24 hours and correcting the timing of the first dosage," the authors write. "We decided to reduce all antibiotic prophylaxis to one dose because this measure could safely promote savings for our institution." Under the new protocol, for most procedures, patients are given one 1-gram dose of the antibiotic cephazolin at the same time anesthesia is administered. The protocol was approved by surgeons prior to implementation; education was provided to surgical and medical staff. To assess the effectiveness of this approach, the researchers examined infection rates and costs for 6,140 consecutive patients who had surgery between February 2002 and October 2002 and 6,159 consecutive patients who had surgery between December 2002 and August 2003, following the implementation of the one-dose protocol.
The correct protocol was followed in 6,123 (99 percent) of the surgeries performed after the new guidelines were implemented. Surgical site infections occurred in 127 (2 percent) of surgeries performed under the 24-hour protocol and 133 (2.1 percent) performed under the one-dose protocol. The number of vials of cephazolin purchased decreased from 1,259 in the first time period to 467 in the second, a 63 percent decline that represented a monthly cost savings of $1,980 for this drug alone.
The cooperation and encouragement of hospital administration and clinical staff, as well as educational efforts, contributed to the success of the new protocol, the authors write. "We were able to demonstrate that one-dose prophylaxis is feasible," they conclude. "In this era of restricted hospital budgets and increased bacterial resistance, one-dose prophylaxis may provide a way to improve performance by lowering costs."
JAMA and Archives Journals
The correct protocol was followed in 6,123 (99 percent) of the surgeries performed after the new guidelines were implemented. Surgical site infections occurred in 127 (2 percent) of surgeries performed under the 24-hour protocol and 133 (2.1 percent) performed under the one-dose protocol. The number of vials of cephazolin purchased decreased from 1,259 in the first time period to 467 in the second, a 63 percent decline that represented a monthly cost savings of $1,980 for this drug alone.
The cooperation and encouragement of hospital administration and clinical staff, as well as educational efforts, contributed to the success of the new protocol, the authors write. "We were able to demonstrate that one-dose prophylaxis is feasible," they conclude. "In this era of restricted hospital budgets and increased bacterial resistance, one-dose prophylaxis may provide a way to improve performance by lowering costs."
JAMA and Archives Journals
Antibiotic News and Current Antibiotic Events RSSStick with simple antibiotics for pneumonia to avoid super bugs, says researcher
Australian hospitals should avoid prescribing expensive broad-spectrum antibiotics for pneumonia to avoid the development of more drug-resistant super bugs, according to a University of Melbourne study.
Trends in prescription medication sharing among reproductive-aged women
Borrowing and sharing of prescription medications is a serious medical and public health concern.
Researchers uncover molecule that keeps pathogens like salmonella in check
Scientists at UT Southwestern Medical Center have found a potential new way to stop the bacteria that cause gastroenteritis, tularemia and severe diarrhea from making people sick.
ETH Zurich study on salmonella self-destruction
ETH Zurich biologists, led by Professors Martin Ackermann and Wolf-Dietrich Hardt, in collaboration with Michael Doebeli of the University of British Colombia in Vancouver (CN), have been able to describe how random molecular processes during cell division allow some cells to engage in a self-destructive act to generate a greater common good, thereby improving the situation of the surviving siblings.
Silver is the key to reducing pneumonia associated with breathing tubes
People have long prized silver as a precious metal. Now, silver-coated endotracheal tubes are giving critically ill patients another reason to value the lustrous metal.
New method to overcome multiple drug resistant diseases developed by Stanford researchers
Many drugs once considered Charles Atlases of the pharmaceutical realm have been reduced to the therapeutic equivalent of 97-pound weaklings as the diseases they once dispatched with ease have developed resistance to them.
Molecular sleuths track evolution through the ribosome
A new study of the ribosome, the cell's protein-building machinery, sheds light on the oldest branches of the evolutionary tree of life and suggests that differences in ribosomal structure between the three main branches of that tree are "molecular fossils" of the early evolution of protein synthesis.
Caltech engineers build mini drug-producing biofactories in yeast
Researchers at the California Institute of Technology have developed a novel way to churn out large quantities of drugs, including antiplaque toothpaste additives, antibiotics, nicotine, and even morphine, using mini biofactories--in yeast.
How flesh-eating bacteria attack the body's immune system
"Flesh-eating" or "Strep" bacteria are able to survive and spread in the body by degrading a key immune defense molecule, according to researchers at the University of California, San Diego, School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences.
Adverse reactions to antibiotics send thousands of patients to the ER
Adverse events from antibiotics cause an estimated 142,000 emergency department visits per year in the United States, according to a study published in the September 15, 2008 issue of Clinical Infectious Diseases.
More Antibiotic News Articles
 | Applied Clinical Pharmacokinetics by Larry A. Bauer >The easiest and most trusted way to learn the clinical application of pharmacokinetics The most current, hands-on book in the field, Applied Clinical Pharmacokinetics gives you clear and useful coverage of drug dosing and drug monitoring that no other text can match. It offers the latest standardized techniques and approaches to patient-specific dosing plus new information on more recently... |
 | Herbal Antibiotics: Natural Alternatives for Treating Drug-Resistant Bacteria (Storey Medicinal Herb Guide) by Stephen Harrod Buhner Current information about antibiotic resistant microbes and the herbs that are effective in fighting... |
 | When Antibiotics Fail: Lyme Disease and Rife Machines, with Critical Evaluation of Leading Alternative Therapies by Bryan Rosner There are enough books and websites about what Lyme Disease is and which ticks carry it. But there is very little useful information for people who actually have a case of Lyme Disease that is not responding to conventional antibiotic treatment. Lyme Disease sufferers need to know how to get better, not how to identify a tick. This book is about how experimental frequency devices known as... |
 | The Cure Is in the Cupboard: How to Use Oregano for Better Health (Revised Edition) by Cass Ingram, Cass Igram |
 | Antibiotic Basics for Clinicians: Choosing the Right Antibacterial Agent (Point (Lippincott Williams & Wilkins)) by Alan R Hauser Designed for quick, easy comprehension, this handbook reference will assist medical students in understanding the rationale behind antibiotic selection for common bacterial pathogens and infectious disease presentations. By supplying the rationale for choosing antibiotics, the book reduces the amount of memorization necessary for proper antibiotic prescribing. The book is heavily illustrated... |
 | Harvard Medical School Guide to Healing Your Sinuses (Harvard Medical School Guides) by Ralph Metson, Steven Mardon From a leading expert at one of the world's most respected medical schools----learn how to beat sinus infections once and for all. Nobody needs to tell you how painful and annoying sinus problems can be--the pounding headaches and congestion, the perpetually runny nose, and the debilitating fatigue, not to mention sleepless nights, lost work, and ruined vacations. Now you can do something about... |
 | Antibiotics Pocketcard 2008 by Herbert Hof Antibiotics pocketcard provides an initial choice of antimicrobial therapy for most common infections. These empirical therapies cover more than 90% of everyday scenarios. The reverse side of this durable plastic card shows a table of antimicrobial spectra for the most important antibiotics. 2008 edition, completely updated! Initial choice of antimicrobials for: CNS, heart, blood,... |
| Antibiotic Essentials 2008 by Burke A. Cunha Antibiotic Essentials is a concise, practical, and authoritative guide to the treatment and prevention of infectious diseases commonly encountered in adults. It covers 542 clinical infectious disease syndromes, HIV infection, 134 detailed drug summaries, pediatric infectious diseases, and a chest x-ray atlas. Topics include: * Empiric Therapy Based on Clinical Syndrome * Initial Therapy Based on... | |
 | Antibiotics Simplified by Jason Gallagher Antibiotics Simplified is a succinct guide designed to bridge knowledge gained in basic sciences courses with clinical practice in infectious diseases. Introductory chapters explain the rationale behind the treatment of infectious diseases, describe a system for selecting antimicrobial agents and briefly review basic microbiology. Later chapters present relevant characteristics of drug classes,... |
 | Scleroderma: The Proven Therapy that Can Save Your Life by Henry Scammell Scleroderma, which affects as many as 400,000 Americans, starts off like skin cancer but is far more deadly. This new edition is updated with new information about the best therapy for this disease, including the results of the landmark first, and a new, second clinical trial of the only therapy to report reversal and remission of this deadly... |
| © 2008 BrightSurf.com |