Surgical infections
-
Surgical infections · Jan 2002
Impact of community-acquired infection on acquisition of nosocomial infection, length of stay, and mortality in adult blunt trauma patients.
The incidence of community-acquired infections (CA) and how it relates to the incidence of nosocomial infections (NI) in the adult blunt trauma population is unknown. We evaluated this incidence and assessed the impact of age on morbidity and mortality. Prospective data were collected on blunt trauma patients admitted >48 h over a 2-year period. ⋯ The combination of CA and NI led to the most significant increases in HLOS, ILOS, and mortality. Increased age is associated with a significantly higher incidence of CA, ILOS, HLOS, and mortality. Once infected with both CA and NI, younger patients have a greater risk of mortality.
-
Surgical infections · Jan 2002
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialErtapenem versus piperacillin-tazobactam for treatment of mixed anaerobic complicated intra-abdominal, complicated skin and skin structure, and acute pelvic infections.
Anaerobes are an important component of many serious, deep tissue infections, especially complicated intra-abdominal (IAI), complicated skin and skin structure (SSSI), and acute pelvic (PI) infections. This study compares the efficacy of ertapenem, 1 g once a day, in the treatment of adults with anaerobic IAI, SSSI, and PI to piperacillin-tazobactam, 3.375 g every 6 hours. ⋯ In this subgroup analysis, ertapenem was as effective as piperacillin-tazobactam for treatment of adults with moderate to severe anaerobic IAI, SSSI, and PI, was generally well tolerated, and had a similar safety profile.
-
Surgical infections · Jan 2002
Randomized Controlled Trial Comparative Study Clinical TrialA pilot study to determine the feasibility of continuous cefazolin infusion.
Animal studies have shown that continuous infusion of beta-lactam antibiotics is more effective than intermittent dosing. We studied several dosing regimens of cefazolin in humans to determine safety and whether or not adequate serum and tissue antibiotic concentrations could be achieved in patients undergoing cardiac bypass. ⋯ Cefazolin administered as a large preoperative bolus with continuous intraoperative infusion resulted in higher serum and tissue concentrations when compared with conventional intermittent dosing. Pharmacodynamically, continuous infusion of beta-lactam antibiotics may be superior to intermittent dosing when used for perioperative prophylaxis against wound infection, especially for cases in which the antibiotic is not redosed intraoperatively.
-
Surgical infections · Jan 2002
Clinical TrialEpidural catheter colonization is not associated with infection.
Epidural anesthesia is one of the most common types of regional anesthesia. Although retrospective reviews suggest that the incidence of infection from short-term epidural catheter use is exceedingly low in patients undergoing surgery, the correlation between epidural catheter cultures and infection has not been well defined. The purpose of this study was to determine the frequency of bacterial colonization of epidural catheters in adult patients undergoing surgery under epidural anesthesia, as well as the correlation between epidural catheter cultures and infection. ⋯ The contamination of epidural catheters was found to be independent of the administered antimicrobial agents prior to surgery, the duration of catheter placement, and the presence of fever. Except for perioperative prophylaxis, therapeutic use of antibiotics for short-term epidural catheters is not recommended.