Archive for February 18, 2013

Antimicrobial Prophylaxis for Surgery: An Advisory Statement from the National Surgical Infection Prevention Project

Clin Infect Dis    15 June 2004 

Dale W. Bratzler and Peter M. Houck, for the Surgical Infection Prevention Guidelines Writers Workgroup Oklahoma Foundation for Medical Quality, Oklahoma City, Oklahoma; and Centers for Medicare and Medicaid Services, Seattle, Washington

In January 2003, leadership of the Medicare National Surgical Infection Prevention Project hosted the Surgical Infection Prevention Guideline Writers Workgroup (SIPGWW) meeting. The objectives were to review areas of agreement among the most-recently published guidelines for surgical antimicrobial prophylaxis, to address inconsistencies, and to discuss issues not currently addressed. The participants included authors from most of the groups that have published North American guidelines for antimicrobial prophylaxis, as well as authors from several specialty colleges. Nominal group process was used to draft a consensus paper that was widely circulated for comment. The consensus positions of SIPGWW include that infusion of the first antimicrobial dose should begin within 60 min before surgical incision and that prophylactic antimicrobials should be discontinued within 24 h after the end of surgery. This advisory statement provides an overview of other issues related to antimicrobial prophylaxis, including specific suggestions regarding antimicrobial selection.


February 18, 2013 at 3:35 pm

Tinidazole versus cefazolin in antibiotic prophylaxis of vaginal and abdominal hysterectomy.

Rev Bras Ginecol Obstet. 2008 Nov;30(11):544-9.

[Article in Portuguese]

Simões JA, Discacciati MG, Poletti GB, Brolazo E, Crema GD, Pereira CF.


Departamento de Tocoginecologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.



to compare the efficacy of tinidazole and cephazolin on the febrile and infectious morbidity of post vaginal and abdominal hysterectomy antibiotic prophylaxis.


randomized clinical study, where women admitted to hospital for hysterectomy were randomly allocated in one of the following antibiotic prophylaxis groups: Group C (2 g of IV cephazolin in the anesthetic induction); Group T (2 g of tinidazole orally, 12 hours before the surgery); or Group C+T (2 g of tinidazole orally 12 hours before the surgery and 2g of IV cephazolin in the anesthetic induction). Cervicovaginal smears were collected for specific cultures and the diagnosis of bacterial vaginosis (BV) was based in Amsel and Nugent’s criteria. The patients were reevaluated 7 and 30 days after the surgery for signs of febrile and/or infectious morbidity. The chi2 or the Fisher’s exact test was used to assess differences among the three groups, with a significance level of 5%. The sample power (1-beta) was calculated through the SAS program.


seven days after the hysterectomy, infectious morbidity was diagnosed in 6.6% of the women, but with no significant difference among the three groups studied (p=0.12). There was no febrile or infectious morbidity at the immediate post-surgical period or after 30 days from the surgery. BV ratio at the pre-surgical period was significantly higher among the women submitted to vaginal hysterectomy, rather than among the ones submitted to abdominal hysterectomy (27 versus 7%, p=0.02). BV ratio was also higher after 30 days, among the women submitted to vaginal hysterectomy (20 versus 8%), though without statistical significance (p=0.19).


the use of tinidazole, isolated or associated with cephazolin has not presented higher efficacy, than the use of cephazolin, alone to prevent febrile or infectious morbidity post hysterectomy. The high ratio of BV at the immediate pre-surgery period among the women submitted to vaginal hysterectomy suggests that this infection must be better investigated and properly treated before the surgery.



February 18, 2013 at 3:34 pm

Pelvic inflammatory disease caused by Streptococcus pneumoniae in a heavy smoker after laparoscopic surgery.

Ann Acad Med Singapore. 2012 Jul;41(7):309-10.


Mack E, Wee HY.



February 18, 2013 at 3:31 pm


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