• Journal of Chest Surgery
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• 제18권4호
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• pp.740-745
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• 1985

A retrospective double blind study comparing 7 day with 2 day regimen of antibiotic prophylaxis was conducted among 200 patients undergoing open heart surgery. No case of endocarditis and wound infection occurred. Pneumonia developed in 5 cases of the 7 day and 1 case of the 2 day group. Urinary tract infection without clinical significance developed in 1 case of the 7 day and 3 cases of the 2 day group. Bacteremia developed in 2 cases of the 7 day and 1 case of the 2 day group. We concluded as follows: l. Administration of antibiotics for 2 days appears to be without substantial risk of infection comparing long term 7 day regimen. 2. 7 days of antibiotics may actually increase the risk of serious infection such as nosocomial pneumonia, and predispose to the development of infections with fungi or antibiotic resistant bacteria. 3. 2 days of prophylaxis is more beneficial than long term 7 day regimen for example economically.

• Childhood Kidney Diseases
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• 제20권1호
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• pp.1-5
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• 2016

Since many years, continuous low dose antibiotic prophylaxis (CAP) has been used for children at a risk for recurrent urinary tract infection (UTI), especially those with vesicoureteral reflux (VUR). The incidence of recurrent UTI has been shown to be higher in children with VUR with bladder and bowel dysfunction (BBD) than in those with VUR without BBD. Therefore, CAP has been recommended for children with BBD and VUR because of the increased risk of UTI. However, the use of CAP has become highly controversial because of bacterial resistance developed due to antibiotic over-usage. The preventive effects of probiotics have been proved in various adult urogenital infections, and the antimicrobial activities of lactobacilli against uropathogens have been demonstrated in previous in vitro studies. However, a critical assessment of their efficacy in children with UTI is lacking. The importance of the use of urogenital probiotics is that it is a natural approach that replenishes the depleted normal flora to create a better environment to fight off uropathogens. Probiotics have a great potential, particularly today with the increasing threat of antibiotic-resistant microorganisms.

• 대한소아치과학회지
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• 제27권2호
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• pp.208-215
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• 2000

선천성 심장질환 환자는 감염성 심내막염에 감수성을 가지고 있고, 치과치료후에 균혈증에 의해서 감염성 심내막염이 발생할 수 있다. 따라서 선천성 심장질환 환자에 있어서 감염성 심내막염을 유발할 수 있는 치과치료를 시행 시에는 예방적항생제의 투여가 추천된다. 1997년 미국 심장학회에서는 감염성 심내막염의 예방을 위한 개정된 지침을 발표하였다. 개정된 지침은 예방적 항생제 투여의 적응증, 항생제의 선택, 투여용량 등에 있어서 이전의 지침과 차이가 있다. 이전의 지침은 출혈을 유발할 수 있는 모든 치과시술에 대해서 예방적 항생제의 투여를 추천하고 있으나 개정된 지침은 술자의 판단에 따라 심한 출혈이 있는 경우에만 예방적 항생제를 투여할 것을 추천하고 있다. 또한 이전의 지침에선 술전과 술후 2회의 예방적 항생제 투여를 추천하였으나 개정된 지침에서는 술후 투여가 없어지고 술전 1회만 예방적 항생제를 투여 할 것을 추천하고 있다. 본 증례는 미국심장학회에서 최근에 발표한 선천성 심장질환 환자의 치과치료시의 예방적 항생제 투여 지침에 따라서 3명의 선천성 심장질환 환아를 대상으로 치과치료 후 그 예후를 관찰한 것이다.

• Childhood Kidney Diseases
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• 제9권1호
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• pp.46-55
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• 2005

목 적 : 일차성 방광요관역류 소아에서 재발성 요로감염은 신반흔의 원인으로 장기간 저용량 항생제 예방요법이 권장되어 왔다. 그러나 최근 항생제 예방요법의 효과에 대한 의문이 제기되었고 항생제 내성에 대한 우려도 있었다. 이에 일차성 발광요관역류 소아에서 항생제 예방요법의 효과에 대한 기초자료를 얻기 위하여 항생제 예방요법에 발생한 재발성 요로감염의 빈도와 위험요인을 조사하고자 하였다 방 법 : 1995년 3월부터 2001년 12월까지 이대목동병원 소아과에서 첫 발열성 요로감염 후에 일차성 방광요관역류가 발견되어 1년간 저용량의 trimethoprim-sulfimethoxazole을 투여 받은 91명을 후향적으로 조사하여 재발성 요로감염의 빈도와 요로감염의 위험요인들을 분석하였다. 결 과 : 재발성 요로감염은 31.9%(29/91)에서 발생하였고 이는 0.32회/환자년 이였다. 발열성 요로감염은 0.26회/환자년이였고 비발열성 요로 감염은 0.07회/환자년이였다. 포경 남아에서 요로 감염의 재발율은 37.2%(19/54)로 포경이 없는 남아의 0%(0/5)에 비하여 유의하게 높았다(P=0.025). 위험 예측치는 신반흔에서만 유의하게 높았다[RR=3.8(95% CI 1.0-14.1), P=0.04]. 여아, 연령, 급성신우신염, 배뇨장애 및 원인균 등은 위험인자로 작용하지 않았고 방광요관역류의 정도에 짜른 유의한 차이도 없었다. .결 론 : 일차성 방광요관역류가 있는 소아에서 항생제 예방요법은 요로감염의 재발을 억제하지 못히였다. 포경과 신반흔이 재발성 요로감염의 위험요인이였고 방광요관역류의 정도에 따른 차이는 없었다. 일차성 방광요관역류 소아에서 우선적으로 포경과 신반흔이 없는 소아에서부터 항생제 예방요법을 시행하지 않는 무작위 대조연구가 필요할 것으로 생각된다.

• 대한두개안면성형외과학회지
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• 제9권2호
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• pp.67-71
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• 2008

Purpose: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. Methods: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. Results: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1 mm and non-prophylactic antibiotics injection group was 2.1 mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). Conclusions: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.

• 한국임상약학회지
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• 제12권2호
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• pp.65-70
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• 2002

Prophylactic antibiotics in acute nonperforated appendicitis have been used for preventing infection after appendectomy. However, duration of antibiotic administration for surgical prophylaxis in Korea has been noted to be longer than those recommended in other countries. The objective of this study was to identify appropriate duration of prophylactic antibiotics in acute nonperforated appendicitis by comparing two different antibiotic regimens for their wound infection rates. Eighty-four acute nonperforated appendicitis patients were enrolled in this prospective, randomized, open trial and were assigned to one of two antibiotic regimens: cefoxitin 1 g every 8 hours given intravenously for 24hours or cefoxitin 1 g every 8 hours given intravenously plus sisomicin 75 mg every 12 hours given jntramuscularly for 72 hours. First doses were given just prior to the induction of anesthesia. Postoperative wound infections were detected in $4.8\%$ of the 72-hour-treated group (n=42), whereas none occurred in the 24-hour-treated group (n=42). However, the difference in the rates of wound infections between two groups was not statistically significant. The most frequently isolated microorganism from appendiceal tissues was E coli. In conclusion, administration of cefoxitin alone for 24 hours is sufficient as surgical prophylaxis in nonperforated appendicitis.

• 대한두개안면성형외과학회지
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• 제22권5호
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• pp.254-259
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• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• Journal of Gastric Cancer
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• 제19권4호
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• pp.451-459
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• 2019

Purpose: Laparoscopic surgery is associated with lower surgical site infection (SSI) rates due to minimal skin incision and non-exposure of visceral organs. Most previous studies have analyzed the efficacy of prophylactic antibiotic use in open surgery. Here, we investigated the feasibility of total laparoscopic distal gastrectomy (TLDG) for gastric carcinoma without prophylactic antibiotic use. Materials and Methods: Seventy-one patients who underwent TLDG without prophylactic antibiotic use were 1:1 propensity score matched with 393 patients who underwent TLDG with antibiotic prophylaxis. The short-term surgical outcomes, including SSI rates, were compared between the groups. Results: After matching, 65 patients were selected in each group. The baseline clinicopathological characteristics were well balanced in the matched sample. In the matched group, there was no significant increase in postoperative morbidity in the non-prophylactic group compared with the prophylactic group (18.5% vs. 15.4%, P=0.640), and there were no grade 3≤ complications (1.4% vs. 0%, respectively; P=1.000). The SSI rates in the non-prophylactic and prophylactic groups were 3.1% and 1.5%, respectively (P=0.559). The time to gas passage, diet initiation, and mean hospital stay were not significantly different between the 2 groups. The SSI rate did not increase in the non-prophylactic group in the different subgroups based on different clinicopathological characteristics. Conclusions: Postoperative morbidity, including SSI rates, did not significantly increase in patients undergoing TLDG without prophylactic antibiotic use. A large prospective randomized trial is warranted to reappraise the efficacy of prophylactic antibiotic use in patients undergoing TLDG.

• The Korean Journal of Pain
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• 제36권1호
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• pp.11-50
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• 2023

As the field of interventional pain management (IPM) grows, the risk of surgical site infections (SSIs) is increasing. SSI is defined as an infection of the incision or organ/space that occurs within one month after operation or three months after implantation. It is also common to find patients with suspected infection in an outpatient clinic. The most frequent IPM procedures are performed in the spine. Even though primary pyogenic spondylodiscitis via hematogenous spread is the most common type among spinal infections, secondary spinal infections from direct inoculation should be monitored after IPM procedures. Various preventive guidelines for SSI have been published. Cefazolin, followed by vancomycin, is the most commonly used surgical antibiotic prophylaxis in IPM. Diagnosis of SSI is confirmed by purulent discharge, isolation of causative organisms, pain/tenderness, swelling, redness, or heat, or diagnosis by a surgeon or attending physician. Inflammatory markers include traditional (C-reactive protein, erythrocyte sedimentation rate, and white blood cell count) and novel (procalcitonin, serum amyloid A, and presepsin) markers. Empirical antibiotic therapy is defined as the initial administration of antibiotics within at least 24 hours prior to the results of blood culture and antibiotic susceptibility testing. Definitive antibiotic therapy is initiated based on the above culture and testing. Combination antibiotic therapy for multidrug-resistant Gram-negative bacteria infections appears to be superior to monotherapy in mortality with the risk of increasing antibiotic resistance rates. The never-ending war between bacterial resistance and new antibiotics is continuing. This article reviews prevention, diagnosis, and treatment of infection in pain medicine.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.121-123
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• 2019

Urinary tract infection is common in the pediatric population. The most common causative agents are bacteria, among which Escherichia coli is the most frequent uropathogen. Although fungal urinary tract infection is rare in the healthy pediatric population, it is relatively common among hospitalized patients. Fungus may be isolated from the urine of immunocompromised patients or that of patients with indwelling catheters. The most common cause of funguria is Candida albicans. Although more than 50% of Candida isolates belong to non-albicans Candida, the prevalence of non-albicans candiduria is increasing. Herein, we report a case of community-acquired candiduria in a 4-month-old immunocompetent male infant who had bilateral vesicoureteral reflux and was administered antibiotic prophylaxis. He was diagnosed with urinary tract infection caused by Candida lusitaniae and was managed with fluconazole.