• Women's Health Nursing
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• v.23 no.1
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• pp.42-51
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• 2017

Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

• Archives of Craniofacial Surgery
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• v.9 no.2
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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.

• Korean Journal of Clinical Pharmacy
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• v.22 no.4
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• pp.324-329
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• 2012

The most common complication after liver transplantation (LT) is bacterial infection. The incidence of surgical site infections (SSIs) after LT was variable from 8.8%~37%. However, there has been no confirmed guideline in use of prophylactic antibiotics after LT. Ampicillin/sulbactam has been used as main prophylactic antibiotics after LT in Seoul National University Hospital (SNUH) according to the center protocol. The purpose of this study was to determine the incidence and risk factors for SSI after LT and to evaluate the appropriateness of prophylactic antibiotics. A total of 211 patients who underwent LT between July 2008 and June 2010 at SUNH were included. During study period, ampicillin/sulbactam was selected as prophylactic antibiotics in 140 patients (66.4%). A total of 43 patients (20.4%) developed infections and the incidence of SSI was noted in 28 patients (13.2%); 10.0% in ampicillin/sulbactam group and 19.4% in other antibiotics (p=0.049). The most common pathogen of SSI was MRSA (13 episodes, 49.4%). In multivariate analysis, choledochojejunostomy (OR: 7.0; 95% CI, 2.4-20.0) and lower serum albumin (OR: 3.7; 95% CI, 1.1-12.9) were found to be risk factors of SSIs. In conclusion, the incidence of SSIs after LT in this population was similar to those in other studies. Therefore, the prophylactic antibiotics protocol in LT at SNUH seems to be appropriate.

• Archives of Plastic Surgery
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• v.51 no.1
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• pp.36-41
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• 2024

Background Among breast reconstruction methods, implant-based breast reconstruction has become the mainstream. However, periprosthetic infection is still an unresolved problem. Although published articles have revealed that limited use of antibiotics is sufficient to reduce infection rates, the number of surgeons still preferring elongated usage of antibiotics is not less. The aim of our study is to validate the appropriate duration of antibiotic use to reduce infection rate after implant-based breast reconstruction. Methods A retrospective study reviewed medical record of 235 patients (274 implants for reconstruction) who underwent prepectoral direct to implant breast reconstruction using acellular dermal matrix wrapping technique. Infection rates were analyzed for the patients administered postoperative prophylactic antibiotics until drain removal and those who received only perioperative prophylactic antibiotics for 24 hours. Results Of the 274 implants, 98 who were administered prophylactic antibiotics until drain removal had an infection rate of 3.06% (three implants) and 176 who received prophylactic antibiotics no longer than 24 hours postoperatively had an infection rate of 4.49% (eight implants). A total of 11 patients diagnosed with postoperative infection clinically, 8 were salvaged by antibiotic treatment, and 3 had implant removal and replacement with autologous flap. Postoperative antibiotic prophylaxis duration had no statistically significant effects in the risk of infection (p = 0.549). Conclusion The duration of prophylactic antibiotics after surgery was not related to infection risk. Further study with a large number of patients, randomized control study, and route of antibiotics is needed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.4
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• pp.240-249
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• 2018

Purpose: The study was done to explore whether the duration of perioperative prophylactic antibiotics therapy influenced uncertainty of recovery in patients with elective laparoscopic uterine myomectomy. Methods: A prospective study was conducted using self-report questionnaires and electrical medical records for patients with uterine myomectomy. According to the length of the perioperative prophylactic antibiotics therapy, the patients were divided into three groups: single-dose antibiotic treatment group, short-term antibiotic treatment group, and long-term antibiotic treatment group. Data were collected from December 20, 2016 to July 31, 2017 from 161 patients who underwent laparoscopic myomectomy at a metropolitan city general hospital. Results: Level of uncertainty of recovery was $2.98{\pm}0.22$. The uncertainty was highest in the long-term antibiotic treatment group, followed by the short-term antibiotic treatment group and the single-dose antibiotic treatment group (F=89.40, p<.001). In the regression analysis, factors influencing uncertainty of recovery among uterine myomectomy patients were duration of perioperative prophylactic antibiotic therapy (${\beta}=.70$, p<.001) and duration of NPO (${\beta}=-.11$, p=.047) which explained 51.5% of the variance (F=83.75, p<.001). Conclusion: Based on these results, information including the administration of antibiotics before surgery should be provided to the patients to help reduce the uncertainty of postoperative recovery.

• Kosin Medical Journal
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• v.33 no.2
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• pp.245-251
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• 2018

Prophylactic antibiotics that are used to prevent post-operative infection can commonly cause anaphylactic reactions during anesthesia. It is therefore necessary to perform a skin test before antibiotics are administered in order to diagnose and prevent anaphylactic reactions. However, the results of the antibiotic skin test can differ according to the drug, dose, and reagent concentration. We report a case of anaphylactic shock with bronchospasm and cardiovascular collapse immediately following administration of the prophylactic cefazedone after induction of general anesthesia for laparoscopic cholecystectomy.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.71-78
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• 2012

Background : The objective of this study was to examine the effect of management system for the appropriate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010. Methods : We collected clinical data of three different surgical procedures(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the antibiotics prescription days after surgery. To evaluate the effectiveness of the management system, the results of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher's exact test. Result : The rate of Aminoglycoside uses decreased drastically from 11.4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). The combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate on discharge declined from 11.8% to 2.5%(P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were significantly improved(except the administration within 1 hour). The rate of surgical site infection decreased from 2.4% to 1.3%(P=.504). Conclusion : The findings demonstrate that the management system for the prophylactic use of antibiotics in surgical patients was effective in decreasing the rate of surgical site infection during 3 years.

• Korean Journal of Clinical Pharmacy
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• v.12 no.2
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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.

• Journal of Digital Convergence
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• v.14 no.6
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• pp.325-333
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• 2016

This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

• Journal of Gastric Cancer
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• v.10 no.4
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• pp.206-211
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• 2010

Purpose: Most surgeons administer prophylactic antibiotics for 3 to 5 days postoperatively. However, the Center for Disease Control (CDC) guideline recommends antibiotic therapy for 24 hours or less in clean/uncontaminated surgery. Thus, we prospectively studied the use of short term prophylactic antibiotic therapy after gastric cancer surgery. Materials and Methods: A total of 103 patients who underwent gastric cancer surgery between October 2007 and June 2008 were prospectively enrolled in a short term prophylactic antibiotics program. One gram of cefoxitin was administered 30 minutes before the incision, and one additional gram was administered intraoperatively for cases with an operation time over 3 hours. Postoperatively, one gram was administered 3 times, every 8 hours. Patients were checked routinely for fever. All cases received open surgery, and the surgical wounds were dressed and checked for Surgical Site Infection (SSI) daily. Results: Of the 103 patients, 15 were dropped based on exclusion criteria (severe organ dysfunction, combined resection of the colon, etc). The remaining 88 patients were included in the short-term program of prophylactic antibiotic use. Of these patients, SSIs were detected in 8 (9.1%) and fever after 2 postoperative days was detected in 11 (12.5%). The incidence of SSIs increased with patient age, and postoperative fever correlated with operation time. Conclusions: Short term prophylactic antibiotic usage is feasible in patients who undergo gastric cancer surgery, and where there are no grave comorbidities or combined resection.