• 제목/요약/키워드: prophylactic

검색결과 473건 처리시간 0.026초

급성 비천공성 충수염 수술시 예방적 항균제의 사용기간 (Appropriate Duration of Prophylactic Antibiotics in Acute Nonperforated Appendicitis)

  • 서옥경;강성희;양대현;신완균
    • 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.

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선택적 복강경하 자궁근종절제술 환자의 예방적 항생제 투여기간이 회복에 대한 불확실성에 미치는 영향 (Influence of Duration of Prophylactic Antibiotics Therapy on Uncertainty of Recovery in Elective Laparoscopic Uterine Myomectomy Patients)

  • 정미영;박경연
    • 기본간호학회지
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    • 제25권4호
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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.

Effects of coagulation factor concentrate prophylaxis in moderate and severe hemophilia A patients at a single hemophilia center in Korea

  • Moon, Byung Suk;Choi, Jun Seok;You, Chur Woo
    • Clinical and Experimental Pediatrics
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    • 제56권7호
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    • pp.291-297
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    • 2013
  • Purpose: The aim of this study was to investigate prophylactic treatment effects in Korean patients with severe hemophilia A. Methods: A prospective study of 32 severe hemophilia A patients was conducted with the approval of the Institutional Review Board at the Eulji University Hospital. Two patients received primary prophylaxis; whereas, the other 30 patients were divided into 2 groups-secondary prophylaxis (n=15) and on-demand (n=15)-on the basis of their consent for secondary prophylaxis. A 20-25 IU/kg dose of factor VIII concentrate was administered to the primary and secondary prophylaxis group patients every 3 days for 1 year. The prophylactic effect was evaluated by observing changes in the Pettersson scores, annual number of total and joint bleeds, and factor VIII consumption for 1 year. Results: No moderate or severe bleeding was observed, and the Pettersson scores remained unchanged during the prophylaxis period in the patients who received primary prophylactic treatment. After the treatment was changed from on-demand to secondary prophylaxis, the annual number of total and joint bleeds in the secondary prophylaxis group decreased by $64.4%{\pm}13.0%$ and $70.0%{\pm}15.2%$, respectively. The average increase in Pettersson scores within 1 year was $0.5{\pm}0.8$ and $1.3{\pm}1.1$ in the secondary prophylaxis and on-demand groups, respectively. Prophylactic effects were also observed in patients >17 years who had nearly the same initial Pettersson scores. Conclusion: Intermediate-dose prophylactic treatment may delay hemarthropathy progression and prevent its occurrence in Korean severe hemophilia A patients.

하악 제 3대구치 발거 후 예방적 항생제의 투여에 관한 연구 (EVALUATION OF POSTOPERATIVE PROPHYLACTIC ANTIBIOTIC MEDICATION IN THIRD MOLAR SURGERY)

  • 전희경;최주석;김평수;안융;고승오
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제31권6호
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    • pp.474-480
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    • 2005
  • We evaluated the need for prophylactic postoperative oral antibiotic medication in extraction of asymptomatic impacted mandibular third molars. All patient didn't show sign of pain, inflammation, swelling and trismus at the time of extraction. In the experimental group, oral antibiotic medication(Amoxicillin) was carried out for 5 days postoperatively. In the control group, the patients received no antibiotic medication. All groups didn't use antibiotic irrigation solution. Rule of group composition randomized. The surgical technique was the same in all cases. Parameters that were evaluated were infection, pain, facial swelling, trismus. We could not find any significant difference between the experimental and control groups.(P<0.05) The results of our study show that post operative oral prophylactic antibiotic medication after the extraction of impacted mandibular third molars does not contribute to less infection, pain, facial swelling and increased mouth opening after surgery. Therefore we suggest that prophylactic postoperative oral antibiotic medication is not needed in extraction of asymptomatic impacted mandibular third molars.

Anaphylaxis occurred immediately after prophylactic antibiotics injection with negative intradermal skin test during laparoscopic cholecystectomy

  • Jeong, Hyung Joo;Kung, Hsi Chiang;Park, Tae Woo;Kang, Dong Hee;Shin, Yu Som;Kim, Ju Deok
    • 고신대학교 의과대학 학술지
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    • 제33권2호
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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.

Optimal Indication of Prophylactic Cholecystectomy for Gallbladder Stones and Polyps in terms of Risk Factors of Gallbladder Cancer

  • Seung Eun Lee
    • Journal of Digestive Cancer Research
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    • 제4권2호
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    • pp.83-87
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    • 2016
  • Till now, two distinct epithelial lesions, dysplasia and adenoma, are currently recognized as premalignant stages of gallbladder (GB) carcinogenesis. In these two carcinogenesis pathways, GB stones and polyps are regarded as one of the most important risk factors of GB carcinoma respectively. Although there still remain controversies for the indication of prophylactic cholecystectomy for GB stones and polyps due to lack of high-level evidence, the present review demonstrated that patients who have GB stones with more than 3 cm size, chronic typhoid carriers, porcelain GB, or anomalous pancreaticobiliary ductal union and patients with more than 1 cm sized GB polyp would be recommended prophylactic cholecystectomy.

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1,250 g 미만 미숙아에서 예방적 Ibuprofen의 효과 (Effect of Prophylactic Ibuprofen in Preterm Infants Less than 1,250 g in Birth Weight)

  • 여문수;최경빈;이현주;박현경;김창렬;설인준
    • Neonatal Medicine
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    • 제18권2호
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    • pp.234-239
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    • 2011
  • 목적: 최근 indomethacin의 대체약으로 ibuprofen이 미숙아 동맥관 개존증의 예방과 치료에 사용되고 있다. 본 연구는 1,250g 미만의 미숙아를 대상으로 ibuprofen의 예방적 치료 효과 및 임상 경과를 분석하고자 하였다. 방법: 2009년 11월부터 2010년 7월까지 본원 신생아 중환자실에 입원한 1,250 g 미만의 동맥관 개존증 환아 39명을 대상으로 후향적으로 의무기록을 조사하였다. Ibuprofen의 예방적 투여군(출생 후 24시간 이내에 ibuprofen 투여) 13명에 대해 재태연령과 출생체중을 과거 대응(historical match)하여 대조군 26명으로 분류하였고, 두 군의 동맥관 개존증 빈도, 임상 경과 및 합병증을 분석하였다. 결과: Ibuprofen을 투여한 예방적 투여군과 대조군 간의 동맥관 폐쇄율(69.2% vs 77.7%, P=0.825)은 유의한 차이가 없었고, ibuprofen 치료에 실패하여 동맥관 결찰술을 시행 받은 경우도 두 군간에 유의한 차이가 없었다(23.1% vs 30.8%, P=0.719). 약물과 관련된 부작용으로 위장관 천공이 발생한 경우는 예방적 투여군에서 더 많은 경향을 보였으나 대상수의 부족 등으로 통계적 유의성은 없었다(30.8% vs 11.5%, P=0.194). 뇌실 내 출혈(grade${\geq}$3) 및 다른 미숙아 합병증의 발생률도 두 군간 차이는 없었다. 결론: 미숙아에서 ibuprofen의 예방적인 투여가 동맥관 폐쇄율, 동맥관 결찰술 그리고 고도의 뇌실 내 출혈의 빈도를 감소시키지 못하였다. 향후 예방적 ibuprofen 사용과 관련하여 효과 및 부작용에 대한 더 많은 연구가 되어야 할 것이다.

Can we omit prophylactic inguinal nodal irradiation in anal cancer patients?

  • Kim, Hakyoung;Park, Hee Chul;Yu, Jeong Il;Choi, Doo Ho;Ahn, Yong Chan;Kim, Seung Tae;Park, Joon Oh;Park, Young Suk;Kim, Hee Cheol
    • Radiation Oncology Journal
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    • 제33권2호
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    • pp.83-88
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    • 2015
  • Purpose: To evaluate the appropriateness of prophylactic inguinal nodal irradiation (PINI), we analyzed patterns of failure in anal cancer patients who were inguinal node-negative at presentation and did not receive PINI. Materials and Methods: We retrospectively reviewed the records of 33 anal cancer patients treated by definitive concurrent chemoradiation therapy (CCRT) between 1994 and 2013. Radiotherapy consisted of a total dose of 44-45 Gy (22-25 fractions in 5 weeks) on the whole pelvis, anus, and perineum. Except inguinal lymphadenopathy was present at initial diagnosis, the entire inguinal chain was not included in the radiation field. In other words, there was no PINI. Results: The median follow-up duration was 50 months (range, 4 to 218 months). Median survival and progression-free survival (PFS) were 57 months (range, 10 to 218 months) and 50 months (range, 4 to 218 months), respectively. Among the survival, the median follow-up duration was 51 months (range, 12 to 218 months). The 5-year overall survival and PFS rates were 93.4% and 88.8%, respectively. Although none of the patients received inguinal node irradiation for prophylactic purposes, there was no inguinal recurrence. Conclusion: Treatment of anal cancer by omitting PINI might be considered in selected patients with clinically uninvolved inguinal nodes.

Malignancy Risk Scoring of Hydatidiform Moles

  • Pradjatmo, Heru;Dasuki, Djaswadi;Dwianingsih, Ery Kus;Triningsih, Ediati
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권6호
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    • pp.2441-2445
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    • 2015
  • Background: Several risk factors leading to malignant transformation of hydatidiform moles have been described previously. Many studies showed that prophylactic chemotherapy for high risk hydatidiform moles could significantly decrease the incidence of malignancy. Thus, it is essential to discover a breakthrough to determine patients with high risk malignancy so that prophylactic chemotherapy can be started as soon as possible. Objectives: Development of a scoring system of risk factors as a predictor of hydatidiform mole malignant transformation. Materials and Methods: This research is a case control study with hydatidiform mole and choriocarcinoma patients as subjects. Multiple logistic regression was used to analyze the data. Odds ratios (OR), attributable at risk (AR : OR-1) and risk index ($ARx{\beta}$) were calculated for develoipment of a scoring system of malignancy risk. The optimal cut-off point was determined using receiver operating characteristic (ROC) curve. Results: This study analyzed 34 choriocarcinoma cases and 68 benign hydatidiform mole cases. Four factors significantly increased the risk of malignancy, namely age ${\geq}35$ years old (OR:4.41, 95%CI:1.07-16.09, risk index 5); gestational age ${\geq}$ 12weeks (OR:11.7, 95%CI:1.8-72.4, risk index 26); uterine size greater than the gestational age (OR:10.2, 95%CI:2.8-36.6, risk index 21); and histopathological grade II-III (OR:3.4, 95%CI:1.1-10.6, risk index 3). The lowest and the highest scores for the risk factors were zero and 55, respectively. The best cut-off point to decide high risk malignancy patients was ${\geq}31$. Conclusions: Malignant transformation of hydatidiform moles can be predicted using the risk scoring by analyzing the above four parameters. Score ${\geq}31$ implies high risk patients so that prophylactic chemotherapy can be promptly administered for prevention.

외과중환자실 환자의 천미골에 적용한 보호필름 드레싱의 예방적 효과 (Prophylactic Effect of Transparent Film Dressing on Sacrum and Coccyx in SICU Patients)

  • 김희정;이선미;최희영;민유경;정유진
    • 기본간호학회지
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    • 제23권3호
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    • pp.256-263
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    • 2016
  • Purpose: This study was done to examine the prophylactic effect of transparent film dressing on the sacrum and coccyx sites to reduce pressure ulcers. Methods: The participants were 317 patients admitted to an SICU in Seoul, Korea. Of the patients, 175 were assigned to the experimental group and 142 to the control group. For participants in the experimental group, a prophylactic transparent film dressing was applied on the sacrum and coccyx. The control group received the usual care. The nurses checked for pressure ulcers on the sacrum and coccyx at least once every duty. When pressure ulcer occurred, it reported on the record form. The results were analyzed using Poisson and Hierarchical logistic regression. Results: The prevalence and risk of pressure ulcer was lower in the experimental group compared to the control group but the difference was not significant. The ICU length of stay was significantly associated with pressure ulcer risk. Conclusion: Findings indicate that prophylactic transparent film dressing helps to reduce pressure ulcer in SICU patients.