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Antibiotic Regimes (antibiotic + regime)

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Medical Sciences	100%

Selected Abstracts

Prosthesis related sepsis following laparoscopic adjustable gastric banding

ANZ JOURNAL OF SURGERY, Issue 7-8 2010
Michael Facek
Abstract Background:, Laparoscopic adjustable gastric banding (LAGB) is well-recognized as a superior method to achieving durable weight loss in the medium term when compared with non-surgical methods of weight loss. In this paper, we described the clinical presentation and outcomes of patients presenting with band or band-adjustment reservoir sepsis from our series from a single institution. Methods:, We conducted a retrospective review of prospectively collected clinical, anthropometric and biochemical data from patients who underwent LAGB placement over a five-year period at a metropolitan teaching hospital. Those patients requiring surgical intervention for prosthesis-related sepsis were included in the review. Results:, Of the 445 patients in this series, 10 (2.2%) developed prosthesis sepsis and required operative intervention. Three (0.7%) presented with reservoir sepsis requiring removal of the reservoir. One had band erosion identified and the entire prosthesis removed. In seven (1.5%) of the patients, infections occurred at the gastric band. Two patients presented with purulent peritonitis and underwent immediate band removal. The remainder presented with band abscesses and either had their band removed (three patients) or left in position and the sepsis treated with drainage and antibiotics (two patients). Conclusions:, In our current series, a small proportion of LAGB patients developed prosthesis-related infection that typically required port or band removal and usually occurred early in the post-operative course. We have modified our prophylactic antibiotic regime and surgical technique as a result of this review. In selected cases of band infection, bands were salvaged with subsequent acceptable weight loss, suggesting that LAGB salvage in the presence of sepsis may be achievable in some patients. [source]

65 Multi-resistant Escherichia coli septicaemia following transrectal ultrasound guided prostate biopsy , an emerging risk

BJU INTERNATIONAL, Issue 2006
A.-J. DAVIDSON
Introduction:, Transrectal ultrasound (TRUS) guided biopsy of the prostate is the standard procedure for diagnosing prostate carcinoma. Complications range from discomfort and bleeding to asymptomatic bacteruria and sepsis. Rarely, sepsis is fatal. E. coli is the most common pathogen causing infection and although no international standard for the use of prophylactic antibiotics exists their use has decreased the incidence of infection to around 2%. Worldwide the incidence of multi-resistant E. coli (MREC) is increasing, and we report two cases of septicaemia secondary to MREC infection postprostate biopsy. Methods:, We performed a review of case records involving postprostate biopsy MREC infection. A comprehensive literature review of TRUS guided biopsy of the prostate was also performed. Results:, All patients in our series had MREC cultured following TRUS guided biopsy of the prostate. All received the same prophylactic antibiotic regime (norfloxacin and gentamicin). They required admission to hospital for intravenous antibiotics and in two cases inotropic support, eventually making full recoveries. All had a history of recent travel to a developing country whilst two had self-limiting diarrhoea and this is the first report in the English literature of MREC following prostate biopsy. Other risk factors for acquiring multi-resistant urinary tract infections have been identified including age and previous quinolone therapy. Conclusion:, Antibiotic prophylaxis for biopsy of the prostate, being predominantly quinolones, will continue to aid in reducing morbidity. However, with the prevalence of MREC increasing current regimens will not cover such organisms potentially leading to sepsis. In our cases travel to developing countries appeared to be a risk factor for being colonised with MREC. We believe through careful history risk factors for multi-resistant urinary tract infection including travel may alert doctors to the potential risk of MREC at the time of biopsy leading to the addition of a broader spectrum antibiotic such as intravenous meropenem. [source]

The periodontal abscess (II).

JOURNAL OF CLINICAL PERIODONTOLOGY, Issue 6 2000
Short-term clinical, microbiological efficacy of 2 systemic antibiotic regimes
Background/aims: The aim of this short-term open parallel longitudinal clinical study was to compare the clinical and microbiological efficacy of 2 different antibiotic regimes in the treatment of acute periodontal abscesses. Method: After patient selection, a clinical examination was carried out recording the following variables: pain, edema, redness, swelling, bleeding on probing, suppuration, tooth mobility, lymphadenopathy, and probing pocket depth. Microbiological samples were taken from the lesion and the patient was randomly assigned to one of two antibiotic regimes: azithromycin or amoxicillin/clavulanate. Clinical variables were recorded, and microbiological samples were taken, at 3,5 days, 10,12 days and 30 days. Additional mechanical treatment (debridement and scaling) was performed in the third visit (10,12 days). Blood and urine samples were collected at baseline and after 10,12 days. Microbiological samples were processed by anaerobic culturing, and isolated periodontal pathogens were tested for antibiotic susceptibility by means of the spiral gradient endpoint methodology. Results: 15 patients took azithromycin, and 14 amoxicillin/clavulanate. Subjective clinical variables demonstrated statistically significant improvements with both antibiotic regimes, which lasted for at least 1 month (p<0.01). Objective clinical variables also showed clear improvements, being statistically significant after 30 days with probing pocket depth in the azithromycin group (p<0.01). Microbiologically, short-term reductions were detected with both antibiotics, however fast recolonization occurred after the third visit. No significant differences were found between both treatment regimes. Antibiotic susceptibilities demonstrated no resistances for amoxicillin/clavulanate, while 2,3 strains of each studied pathogen were resistant to azithromycin. Conclusions: However, both antibiotic regimes were effective in the short-term treatment of periodontal abscesses in periodontitis patients. [source]

Reviewing the efficacy of changing prophylactic measures for the prevention of bisphosphonate related osteonecrosis of the jaws (BRONJ) in the management of oral surgery patients

ORAL SURGERY, Issue 3 2010
C.J. Hanson
Abstract Aims:, Many papers postulate treatments for established bisphosphonate related osteonecrosis of the jaws (BRONJ) or advise on ideal long-term strategies to avoid BRONJ. This article demonstrates prophylactic regimes and compares their outcomes when patients' acute symptoms demand active treatments involving bone. It assesses the efficacy of the protocols developed at Dundee Dental Hospital for prophylaxis of BRONJ in the management of patients undergoing oral surgery. Materials and methods:, This prospective study tracked the progress of patients who were treated in the exodontia clinics and had taken, or were taking bisphosphonates. Their consequent recovery was documented over 1, 4, 12 and 24 weeks. The prophylactic protocol followed was recorded. These data were then reviewed for healing, operator, jaw predilection and co-morbidity influences. Results:, In total, 25 patients were treated over the 1 year period of the study 2008,09. This amounted to 33 oral surgery treatments involving 64 extractions. Several protocols had been followed however these were grouped into: antimicrobial or chlorhexidine based protocols. In all cases, complete healing was achieved. Concomitant steroid use and increasing age were the only associated co-morbidities that increased the length of healing time. There were no direct associations of any of the other variables with healing. No prophylactic protocol was superior to another with chlorhexidine rinses proving as efficacious as any of the antibiotic regimes. Conclusion:, For patients taking oral bisphosphonates, simple extractions carried out with minimal trauma by graduate and supervised undergraduate operators with prophylactic chlorhexidine rinses, heal as satisfactorily as those with antibiotic based protocols for prophylaxis. [source]