Archive for July 27, 2013

Efficacy of single dose of gentamicin in combination with metronidazole versus multiple doses for prevention of post-caesarean infection: study protocol for a randomized controlled trial.

Trials. 2012 Jun 21;13:89.

Lyimo FM, Massinde AN, Kidenya BR, Konje E, Mshana SE.

Source

Department of Obstetrics and Gynaecology, Catholic University of Health Sciences and Allied Science and Bugando Medical Centre, Box 1464, Mwanza, Tanzania.

Abstract

BACKGROUND:

Caesarean section is a commonly performed operation worldwide. It has been found to increase rates of maternal infectious morbidities more than five times when compared to vaginal delivery. Provision of intravenous prophylactic antibiotics 30 to 60 minutes prior to caesarean section has been found to reduce post-caesarean infection tremendously. Many centers recommend provision of a single dose of antibiotics, as repeated doses offer no benefit over a single dose. At Bugando Medical Centre post caesarean infection is among the top five causes of admission at the post-natal ward. Unfortunately, there is no consistent protocol for the administration of antibiotic prophylaxis to patients who are designated for caesarean section. Common practice and generally the clinician’s preference are to provide repeated dosages of antibiotic prophylaxis after caesarean section to most of the patients. This study aims to determine the comparative efficacy of a single dose of gentamicin in combination with metronidazole versus multiple doses for prevention of post caesarean infection.

METHODS/DESIGN:

The study is an interventional, open-label, two-armed, randomized, single-center study conducted at Bugando Medical Centre Mwanza, Tanzania. It is an ongoing trial for the period of seven months; 490 eligible candidates will be enrolled in the study. Study subjects will be randomly allocated into two study arms; “A” and “B”. Candidates in “A” will receive a single dose of gentamicin in combination with metronidazole 30 to 60 minutes prior to the operation and candidates in “B” will receive the same drugs prior to the operation and continue with gentamicin and metronidazole for 24 hours. The two groups will be followed up for a period of one month and assessed for signs and symptoms of surgical site infection. Data will be extracted from a case record form and entered into Epi data3.1 software before being transferred to SPSS version 17.0 for analysis. The absolute difference in proportion of women who develop surgical site infection in the two study arms will be the effectiveness of one regime over the other.

TRIAL REGISTRATION:

Current Controlled Trials ISRCTN44462542.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3475059/pdf/1745-6215-13-89.pdf

July 27, 2013 at 10:11 am

Antibiotics prophylaxis in connection with caesarean section–guidelines at Norwegian maternity departments.

Tidsskr Nor Laegeforen. 2011 Nov 29;131(23):2355-8.

Eriksen HM, Sæther AR, Økland I, Langen E, Sandness Y, Bødtker A, Skjeldestad FE.

Source

Department of Infectious Disease Epidemiology, Norwegian Institute of Public Health, Norway. hmer@fhi.no

Abstract

BACKGROUND:

The frequency of caesarean sections is increasing. Infection in operation wounds and/or underlying spaces and organs is a common complication. In Veileder I fødselshjelp [Clinical Guidelines in Obstetrics], 2008, antibiotic prophylaxis is recommended in the form of single dose ampicillin or first generation cephalosporins in connection with acute caesarean sections and under special conditions such as prolonged operations. We wanted to find out whether Norwegian maternity departments follow these recommendations.

MATERIAL AND METHODS:

All head senior consultants at maternity departments that carried out more than one caesarean section in 2008 were invited to take part in a survey of the department’s written guidelines for use of antibiotic prophylaxis in connection with caesarean section. The extent to which the guidelines were followed was evaluated using data from the Norwegian Surveillance System for Hospital-Associated Infections (NOIS).

RESULTS:

38 of the 42 maternity wards in the investigation had written guidelines for antibiotic prophylaxis. Four of these maternity wards gave prophylaxis in all Caesarean sections, one only on indication, and 33 in acute Caesarean section. The guidelines varied as regards choice of type of antibiotic and time of administration. In the maternity wards with written guidelines recommending use of antibiotic prophylaxis in all Caesarean sections, were practice in accordance with the guidelines. When the guidelines recommended prophylactic use only in acute operations, there was agreement between practice and guidelines in 71 % to 97 % of the patients in the ward.

INTERPRETATION:

Most Norwegian maternity wards have written guidelines on antibiotic prophylaxis in Caesarean section. The contents of the guidelines varied but are mainly in agreement with current Norwegian recommendations

PDF

http://tidsskriftet.no/pdf/pdf2011/2355-8eng.pdf

July 27, 2013 at 10:09 am

A case report of a multi-drug resistant bacterial infection in a diabetic patient treated in northeast Brazil.

Diabet Foot Ankle. 2012;3.

Neto RM, Ansaldi MA Jr, da Costa ME, da Silva SO Jr, Luz VH.

Source

Laboratory Mycobacteria (LABMIC), Department of Microbiology and Parasitology, Center for Biosciences, Federal University of Rio Grande do Norte (UFRN), Natal-RN, Brazil.

Abstract

Diabetes mellitus is one of the most critical health conditions around the world, not only in terms of the number of affected people, disability, and premature mortality, but also in regards to the health care costs involved in controlling and treating its complications. Among the most constant ailments the diabetic patient suffers is the diabetic foot, defined as any infection, ulceration, and/or necrosis of deep tissues associated with neurological abnormalities and various degrees of peripheral vascular disease of the lower limbs. Diabetic foot ulcerations have become a major and increasing public health concern and its associated morbidities, impairment of the patients’ quality of life, and the implied costs for management have attracted the attention of numerous health care providers. In this case report, the authors review a unique presentation of a polymicrobial infection of a multi-drug resistant character species formed by oxacillin-resistant Staphylococcus aureus, Acinetobacter baumannii and Acinetobacter lwoffii.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384988/pdf/DFA-3-18656.pdf

 

 

KEYWORDS: diabetic foot, neuropathy, polymicrobial infection, resistance, ulcer

July 27, 2013 at 10:07 am

Acinetobacter baumannii – An emerging opportunistic pathogen.

Virulence. 2012 May 1;3(3):243-50.

Howard A, O’Donoghue M, Feeney A, Sleator RD.

Source

Department of Biological Sciences, Cork Institute of Technology, Bishopstown, Cork, Ireland.

Abstract

Acinetobacter baumannii is an opportunistic bacterial pathogen primarily associated with hospital-acquired infections. The recent increase in incidence, largely associated with infected combat troops returning from conflict zones, coupled with a dramatic increase in the incidence of multidrug-resistant (MDR) strains, has significantly raised the profile of this emerging opportunistic pathogen. Herein, we provide an overview of the pathogen, discuss some of the major factors that have led to its clinical prominence and outline some of the novel therapeutic strategies currently in development.

PDF

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442836/pdf/viru-3-243.pdf

July 27, 2013 at 10:05 am

Inter-society consensus for the management of respiratory infections: acute bronchitis and chronic obstructive pulmonary disease.

Medicina (B Aires). 2013;73(2):163-73.

[Article in Spanish]

Lopardo G, Pensotti C, Scapellato P, Caberlotto O, Calmaggi A, Clara L, Klein M, Levy Hara G, López Furst MJ, Mykietiuk A, Pryluka D, Rial MJ, Vujacich C, Yahni D.

Source

Sociedad Argentina de Infectología, Argentina. glopardo@intramed.net

Abstract

The Argentine Society for Infectious Diseases and other national societies issued updated practical guidelines for the management of acute bronchitis (AB) and reactivations of chronic obstructive pulmonary disease (COPD) with the aim of promoting rational use of diagnostic and therapeutic resources. AB is a condition characterized by inflammation of the bronchial airways which affects adults and children without underlying pulmonary disease. It is usually caused by a virus. The diagnosis is based on clinical findings after community acquired pneumonia has been ruled out. Treatment of AB is mainly symptomatic. Antibiotics should be used in immune-compromised hosts, patients with chronic respiratory or cardiac diseases and in the elderly with co-morbidities. Reactivation of COPD is defined as an acute change in the patient’s baseline clinical situation beyond normal day to day variations, with an increase in dyspnea, sputum production and/or sputum purulence, warranting a change in medication. An increase in one symptom is considered a mild exacerbation, two as moderate, and the presence of three symptoms is considered a severe exacerbation. An infectious agent can be isolated in sputum in 50 to 75% of COPD reactivations. Moderate and severe episodes must be treated with antibiotics, amoxicillin/beta-lactamase inhibitor, macrolides and fluoroquinolones are first choice drugs.

PDF

http://www.medicinabuenosaires.com/PMID/23570768.pdf

 

 

kewwords: SADI, acute bronchitis, chronic obstructive pulmonary disease, Antibiotics,

July 27, 2013 at 10:03 am


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