• Title/Summary/Keyword: prophylactic

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Prophylactic antibiotics in intra-oral bone grafting procedures: a prospective, randomized, double-blind clinical trial

  • Lee, Jung-Woo;Lee, Jin-Yong;Kim, Soung-Min;Kim, Myung-Jin;Lee, Jong-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.2
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    • pp.90-95
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    • 2012
  • Objectives: This study was conducted in order to assess the efficacy of 1st generation cephalosporin as use as a single-dose preoperative prophylactic antibiotic for surgical wound infections resulting from intra-oral bone grafting procedures. Materials and Methods: A total of 23 patients who were to undergo intra-oral bone graft procedures participated in this study. After randomization, 2 grams of 1st generation cephalosporin was orally administered to both the experimental and placebo groups one hour prior to surgery in a double-blind fashion. Post-operatively, the experimental group (12 patients) was orally administered placebo three times a day for three days. The control group (11 patients) was orally administered 1st generation cephalosporin three times a day for three days. The postoperative course was observed for one month including the clinical parameters associated with infection. Results: Postoperative infections were noted in 1 out of 11 patients in the experimental group. No infections occurred in the control group. Conclusion: There was no significant difference in the incidence of postoperative infections between the two groups. Two grams of 1st generation cephalosporin administered orally one hour before surgery served as an effective prophylactic antibiotics therapy for intra-oral bone graft surgery.

The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital (수술 예방적 항생제의 사용 현황 및 관리전후 효과)

  • Yang, Jiyeon;Kim, Moon-Sook;Kim, Yu-Jeong;Lee, Eun-Bong
    • 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.

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Prophylactic extended-field irradiation with concurrent chemotherapy for pelvic lymph node-positive cervical cancer

  • Oh, Jinju;Seol, Ki Ho;Lee, Hyun Joo;Choi, Youn Seok;Park, Ji Y.;Bae, Jin Young
    • Radiation Oncology Journal
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    • v.35 no.4
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    • pp.349-358
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    • 2017
  • Purpose: This study aimed to evaluate whether prophylactic extended-field pelvic radiotherapy (EF-PRT) yields better results than standard whole pelvic radiotherapy (WPRT) in patients with pelvic lymph node-positive cervical cancer treated with concurrent chemoradiotherapy (CCRT). Materials and Methods: A total of 126 cases of stage IB-IVA cervical cancer that had pelvic lymph node involvement in magnetic resonance imaging and were treated with CCRT between 2000 and 2016 were reviewed. None of the patients had para-aortic lymph node (PALN) metastases. The patients were classified to two groups, namely, those treated with EF-PRT, including prophylactic para-aortic radiotherapy, and those treated only with WPRT. The median dose to the PALN area in patients treated with EF-PRT was 45 Gy. All patients received concurrent cisplatin-based chemotherapy. Results: Overall, 52 and 74 patients underwent EF-PRT and WPRT, respectively. Patient characteristics and irradiated dose were not significantly different, except the dose to the para-aortic area, between the two groups. The median follow-up period was 75.5 months (range, 5 to 195 months). The 10-year cumulative recurrence rate of PALN for EF-PRT vs. WPRT was 6.9% and 10.1% (p = 0.421), respectively. The 10-year disease-free survival and overall survival for EF-PRT vs. WPRT were 69.7% vs. 66.1% (p = 0.748) and 71.7% vs. 72.3% (p = 0.845), respectively. Acute gastrointestinal complications were significantly higher in EF-PRT (n = 21; 40.4%) than WPRT (n = 26; 35.1%) (p = 0.046). Late toxicities were not significantly different in both groups. Conclusion: In this study, prophylactic radiotherapy for PALN does not have an additional benefit in patients with pelvic lymph node-positive cervical cancer treated with CCRT.

Are postoperative prophylactic antibiotics in closed reduction of nasal bone fracture valuable?: prospective study of 30 cases

  • Jang, Nam;Shin, Hyun Woo
    • Archives of Craniofacial Surgery
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    • v.20 no.2
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    • pp.89-93
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    • 2019
  • Background: Prophylactic antibiotic administration after surgery for a nasal bone fracture is performed due to concerns about infection-related complications, such as, toxic shock syndrome. To evaluate the validity and efficacy of antibiotic use, we compared the results obtained and the bacterial profiles of nasal packing materials in patients that underwent closed reduction for a nasal bone fracture with or without prophylactic antibiotic administration. Methods: Thirty consecutive patients with a nasal bone fracture, but without an open wound, that underwent closed reduction during March to August 2017 were included in the present study. Fifteen of these 30 patients were randomly assigned to a control group, members of were administered postoperative intravenous antibiotics once at the day of surgery and then oral antibiotics for 4 days. The other 15 patients were assigned to an experimental group and not administered any antibiotic postoperatively. Antibiotic ointment was not applied to nasal packing in either group. Nasal packing was removed on postoperative day 4 in all cases. Removed nasal gauze packings were culture tested and strains identified in the two groups were compared. Results: Bacterial strain types cultured from packings were similar in the experimental and control groups and no patient showed signs of clinically significant infection. Conclusion: The findings of this study suggest postoperative prophylactic antibiotic use is not clinically required after closed reduction of a nasal bone fracture. Furthermore, the non-use of postoperative antibiotics is biologically beneficial, as it reduces the occurrence of resistant strains and medical costs, and is more convenient for patients.

Effect of Prophylactic Supplementation of Vitamin E and Se on Antioxidant Enzymes during Endotoxic Shock in Buffalo Calves

  • Sandhu, T.S.;Singha, S.P.S
    • Asian-Australasian Journal of Animal Sciences
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    • v.16 no.11
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    • pp.1577-1582
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    • 2003
  • This study was conducted to determine the effects of prophylactic supplementation of vitamin E and Se on oxidative damage and antioxidant status. Fifteen healthy male buffalo (Bubalus bubalis) calves between the age of 6 to12 months were divided into three groups of five animals each: Group I-control, group II-endotoxic shock group infused with lyophilized E coli endotoxin @ 5 ${\mu}g$/kg body wt, and group III-supplemented with vitamin E @ 250 mg and Se @ 7.5 mg, one month prior to induction of endotoxic shock. All the animals in group II and group III exhibited signs of endotoxic shock. When the endotoxic shock was induced, there was significant (p<0.05) increase in the circulating levels of malonyl dialdehyde MDA (an indicator of lipid peroxidation). In the supplemented group III the magnitude of formation of MDA was also less as compared to group II at every stage of study. There was significant (p<0.05) decrease in circulating levels of SOD, GSH-Px, Catalase and G-6-PD activity from the normal (0 h) value with passage of time. As a result of endotoxic shock, these values reached a lowest value, and then showed a tendency towards the 0 h value. Prophylactic supplementation with vitamin E and Se was successful in reducing the quantum of oxidative damage due to formation of free radicals because of endotoxic shock.

Clinical Trial Study about Preventing Winter Diseases through Summer Prophylactic Treatment Using Acupoint Sticking (삼복첩을 이용한 동병하치법에 관한 임상연구고찰)

  • Sung, Hyun-Kyung;Min, Sang-Yeon;Kim, Jang-Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.24 no.2
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    • pp.59-74
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    • 2010
  • Objectives The purpose of this study is to analyzing clinical trials of the current acupoint sticking treatment on Sambok* to prevent winter diseases through summer prophylactic treatment. Methods 33 Chinese clinical studies published in last fifteen years were selected for analysis. Results Acupoint sticking treatment on Sambok* is used in asthma, rhinitis, bronchitis. Commonly used herbs are Sinapis Semen(白芥子), Asari Herba Cum Radix(細辛), Euphorbiae Kansui Radix(甘遂), Corydalis Tuber(玄胡索), Moschi Moschus(麝香), Ephedrae Herba(麻黃), Cinnamomi Cortex Spissus(肉桂) and Commonly used acupoints are Feishu(肺兪), Kohwang(膏肓), Shinsu(腎兪), Pisu(脾兪). 33 studies showed that the effect of treatment in different age, symptom, acupoints, herbs, methods. However, it shows that acupoint sticking treatment on Sambok* is effective in various diseases, especially in respiratory disease. Conclusions This study shows that acupoint sticking treatment on Sambok* is effective in preventing many diseases. More clinical studies about acupoint sticking treatment and standardizations to evaluate effectiveness are needed to prove its efficacy clearly.

Phenytoin Induced Erythema Multiforme after Cranial Radiation Therapy

  • Kazanci, Atilla;Tekkok, Ismail Hakki
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.163-166
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    • 2015
  • The prophylactic use of phenytoin during and after brain surgery and cranial irradiation is a common measure in brain tumor therapy. Phenytoin has been associated with variety of adverse skin reactions including urticaria, erythroderma, erythema multiforme (EM), Stevens-Johnson syndrome, and toxic epidermal necrolysis. EM associated with phenytoin and cranial radiation therapy (EMPACT) is a rare specific entity among patients with brain tumors receiving radiation therapy while on prophylactic anti-convulsive therapy. Herein we report a 41-year-old female patient with left temporal glial tumor who underwent surgery and then received whole brain radiation therapy and chemotherapy. After 24 days of continous prophylactic phenytoin therapy the patient developed minor skin reactions and 2 days later the patient returned with generalized erythamatous and itchy maculopapuler rash involving neck, chest, face, trunk, extremities. There was significant periorbital and perioral edema. Painful mucosal lesions consisting of oral and platal erosions also occurred and prevented oral intake significantly. Phenytoin was discontinued gradually. Systemic admistration of corticosteroids combined with topical usage of steroids for oral lesions resulted in complete resolution of eruptions in 3 weeks. All cutaneous lesions in patients with phenytoin usage with the radiotherapy must be evoluated with suspicion for EM.

Laparoscopic Gastric Wedge Resection and Prophylactic Antireflux Surgery for a Submucosal Tumor of Gastroesophageal Junction

  • Lee, Jeong-Sun;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
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    • v.11 no.2
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    • pp.131-134
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    • 2011
  • A laparoscopic wedge resection for a submucosal tumor, which is close to the gastroesophageal junction, is technically challenging. This can be a dilemma to both patients and surgeons when the tumor margin involves the gastroesophageal junction because a wedge resection in this situation might result in a deformity of the gastroesophageal junction or an injury to the lower esophageal sphincter, which ultimately results in lifelong gastroesophageal reflux disease. The patient was a 42 year-old male, whose preoperative endoscopic ultrasonographic finding did not rule out a gastrointestinal stromal tumor. He underwent a laparoscopic gastric wedge resection and prophylactic anterior partial fundoplication (Dor) and was discharged from hospital on the fifth postoperative day without any complications. There were no symptoms of reflux 5 months after surgery. A laparoscopic wedge resection and prophylactic anti-reflux surgery might be a good surgical option for a submucosal tumor at the gastroesophageal junction.

Clinical Study on Safety and Efficacy of JiSaiXin (Recombinant Human Granulocyte Colony Stimulating Factor Injection Manufactured in China) for Chinese Undergoing Chemotherapy

  • Wang, Lin;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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    • pp.299-301
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    • 2015
  • Objectives: To assess safety and efficacy of JiSaiXin (Recombinant Human Granulocyte Colony Stimulating Factor Injection manufactured in China, G-CSF) 150ug per day for three days and whether this regimen could reduce the incidence of febrile neutropenia caused by chemotherapy. Method: From July 2014 to December 2014 patients treated by chemotherapy in our hospital were randomly divided into two groups: Group A with prophylactic use of G-CSF (JiSaiXin) 24 hours after chemotherapy for consecutive 3 days; and Group B with G-CSF (JiSaiXin) after neutropenia. Routine blood tests were performed 7 days and 14 days after chemotherapy. Results: A total of 100 patients fulfilled study criteria, and the incidence of severe neutropenia (grade III/IV) and the incidence of febrile neutropenia in Group A were lower than those in Group B. Nine patients were found severe neutropenia (grade III/IV) in Group B, but one in Group A, three febrile neutropenia in Group B, but 0 in Group A. Conclusions: This study suggested that prophylactic use of G-CSF (JiSaiXin) 150ug per day 24 hours after chemotherapy for consecutive 3 days is safe and could be effective for preventing febrile neutropenia in patients with chemotherapy.

Safety and Prognostic Impact of Prophylactic Level VII Lymph Node Dissection for Papillary Thyroid Carcinoma

  • Fayek, Ihab Samy;Kamel, Ahmed Ahmed;Sidhom, Nevine FH
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.18
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    • pp.8425-8430
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    • 2016
  • Purpose: To study the safety of prophylactic level VII nodal dissection regarding hypoparathyroidism (temporary and permanent) and vocal cord dysfunction (temporary and permanent) and its impact on disease free survival. Materials and Methods: This prospective study concerned 63 patients with papillary thyroid carcinoma with N0 neck node involvement (clinically and radiologically) in the period from December 2009 to May 2013. All patients underwent total thyroidectomy and prophylactic central neck dissection including levels VI and VII lymph nodes in group A (31 patients) and level VI only in group B (32 patients). The thyroid gland, level VI and level VII lymph nodes were each examined histopathologically separately for tumor size, multicentricity, bilaterality, extrathyroidal extension, number of dissected LNs and metastatic LNs. Follow-up of both groups, regarding hypoparathyroidism, vocal cord dysfunction and DFS, ranged from 6-61 months. Results: The mean age was 34.8 and 34.3, female predominance in both groups with F: M 24:7 and 27:5 in groups A and B, respectively. Mean tumor size was 12.6 and 14.7mm. No statistical differences were found between both groups regarding age, sex, bilaterality, multicentricity or extrathyroidal extension. The mean no. of dissected level VI LNs was 5.06 and 4.72 and mean no. of metastatic level VI was 1 and 0.84 in groups A and B, respectively. The mean no. of dissected level VII LNs was 2.16 and mean no. of metastatic LNs was 0.48. Postoperatively temporary hypoparathyroidism was detected in 10 and 7 patients and permanent hypoparathyroidism in 2 and 3 patients; temporary vocal cord dysfunction was detected in 4 patients and one patient, and permanent vocal cord dysfunction in one and 2 patients in groups A and B, respectively. No significant statistical differences were noted between the 2 groups regarding hypoparathyroidism (P=0.535) or vocal cord dysfunction (P=0.956). The number of dissected LNs at level VI only significantly affected the occurrence of hypoparathyroidism (<0.001) and vocal cord dysfunction (<0.001).The DFS was significantly affected by bilaterality, multicentricity and extrathyroidal extension. Conclusions: Level VII nodal dissection is a safe procedure complementary to level VI nodal dissection with prophylactic central neck dissection for papillary thyroid carcinoma.