Assessment of antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital / Avaliação da antibioticoprofilaxia em pacientes cirúrgicos no Hospital Universitário Gaffrée e Guinle

ABSTRACT Objective : to evaluate the antibiotic prophylaxis in surgical patients at the Gaffrée e Guinle University Hospital - HUGG. Methods : we conducted a rospective study of a cohort of 256 patients undergoing elective operations between January and September 2014. We collected data on demographics, use or not of prophylactic antibiotic and the antibiotic prophylaxis following characteristics: type of antibiotic used, moment of administration and duration of postoperative use. The analyzed outcomes were "justified use or non-use of antibiotic prophylaxis", "correct antibiotic choice," "administration of the antibiotic at the right time" and "discontinuation of the antibiotic at the right time." Results : antibiotic prophylaxis was used in 91.8% of cases. The use or non-use of antibiotic prophylaxis was justified in 78.9% of patients, the choice of the administered antibiotic was considered correct in 97.9%, antibiotic administration was made at the right time in only 27.2% of patients and discontinuation of the antibiotic was performed at the correct time in 95.7% of cases. Conclusion : the surgical antibiotic prophylaxis was not fully adequately performed in the sample.

RESUMO Objetivo: avaliar a antibioticoprofilaxia em pacientes cirúrgicos do Hospital Universitário Gaffrée e Guinle. Métodos: estudo prospectivo de uma coorte de 256 pacientes submetidos à operações eletivas, entre janeiro e setembro de 2014. Foram coletados dados demográficos dos pacientes, se ocorreu utilização ou não do antibiótico profilático e as seguintes características da antibioticoprofilaxia: tipo de antibiótico utilizado, momento da administração e tempo de duração do uso no pós-operatório. Os desfechos de interesse analisados foram "uso ou não uso justificado da antibioticoprofilaxia", "escolha correta do antibiótico", "administração do antibiótico no tempo correto" e "descontinuação do antibiótico no tempo correto". Resultados: a antibioticoprofilaxia foi utilizada em 91,8% dos casos. O uso ou não uso da antibioticoprofilaxia foi justificado em 78,9% dos pacientes, a escolha do antibiótico administrado foi considerada correta em 97,9%, a administração do antibiótico foi feita no momento correto em apenas 27,2% dos pacientes e a descontinuação do antibiótico foi realizada no tempo correto em 95,7% dos casos. Conclusão: a antibioticoprofilaxia cirúrgica não foi realizada de forma plenamente adequada na amostra estudada.

Adherence to guidelines for surgical antibiotic prophylaxis: a review

ABSTRACTCONTEXT AND OBJECTIVES: The appropriate use of antibiotic prophylaxis in the perioperative period may reduce the rate of infection in the surgical site. The purpose of this review was to evaluate adherence to guidelines for surgical antibiotic prophylaxis.METHODS:The present systematic review was performed according to the Cochrane Collaboration methodology. The databases selected for this review were: Medline (via PubMed), Scopus and Portal (BVS) with selection of articles published in the 2004-2014 period from the Lilacs and Cochrane databases.RESULTS:The search recovered 859 articles at the databases, with a total of 18 studies selected for synthesis. The outcomes of interest analyzed in the articles were as follows: appropriate indication of antibiotic prophylaxis (ranging from 70.3% to 95%), inappropriate indication (ranging from 2.3% to 100%), administration of antibiotic at the correct time (ranging from 12.73% to 100%), correct antibiotic choice (ranging from 22% to 95%), adequate discontinuation of antibiotic (ranging from 5.8% to 91.4%), and adequate antibiotic prophylaxis (ranging from 0.3% to 84.5%).CONCLUSIONS:Significant variations were observed in all the outcomes assessed, and all the studies indicated a need for greater adherence to guidelines for surgical antibiotic prophylaxis.

Avaliação do uso da antibioticoterapia profilática no paciente cirúrgico / Evaluation of prophylactic antibiotic use in the surgical patient

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Antibiotics surveillance in pediatrics in-patients, a point prevalence comparative study between kingdom of Bahrain and the European Union

To determine the variation in drug, dose and indications of antimicrobial prescription in children admitted in the hospital and compare the results with the European countries. Point Prevalence Survey [PPS]. All existing pediatric and neonatal wards [medical, surgical, PICU, NICU] within Salmaniya Medical Complex. Data collection was performed using pediatric department and NICU forms. Essential data collected were the patient's biographical data and details about the antibiotics used. The pattern of antibiotics choice and use in Bahrain and the European Union was almost similar in pediatric units. Almost all antibiotics prescribed were on empirical basis. There is a high rate of use of intravenous broad spectrum antibiotics in the pediatric services in Salmaniya Medical Complex for surgical prophylaxis and for medical reasons compared to European Union Centers. The decision to prescribe antimicrobial agents should always be clinically justified and the reasons should be recorded in the patient's medical record. It is important not to prescribe antibiotics on "just in case" basis

Flora bacteriana en agujas de inyección de Ranibizumab en la Fundación Oftalmológica Nacional / Bacterial flora in Ranibizumab injection needles at Fundación Oftalmológica Nacional

Objetivo: describir la prevalencia de contaminación bacteriana de agujas utilizadas en inyecciones intravítreas en pacientes tratados con Ranibizumab, analizar la flora normal conjuntival, identificar el germen más común en cultivos de agujas utilizadas y establecer la eficacia de profilaxis antibiótica preoperatoria en la reducción de la flora normal conjuntival presente en el procedimiento. Métodos: estudio observacional descriptivo tipo serie de casos. Se incluyen pacientes de la Fundación Oftalmológica Nacional sometidos a inyección intravítrea de Ranibizumab desde Abril 6 a Septiembre 28 del 2010. Edades entre 44 - 91 años. Se tomó frotis conjuntival del fondo de saco inferior para cultivo de flora normal al momento de la inyección y de la aguja utilizada y no utilizada. Se siembran muestran en tres medios de cultivo a 37ºC/ 5 días. Resultados: se realizaron 150 cultivos, 50 ojos de 50 pacientes. 44 pacientes (88%) fueron consistentes y se incluyeron en el análisis. 6 (12%) fueron no consistentes. Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Difteroides y Staphylococcus haemolyticus. El Staphylococcus aureus fue la bacteria causal más frecuente contaminante de la aguja utilizada (10%), Difteroides (4%) y Bacillus subtilis (4%). Difteroides, Bacillus subtilis y Staphylococcus aureus fueron los contaminantes de las agujas no utilizadas. El Staphylococcus haemolyticus, aureus, epidermidis y Difteroides fueron cultivados en la flora normal conjuntival de pacientes con cultivo de aguja negativo. El 61.4% de los cultivos no presentaron crecimiento bacteriano. Conclusión: el Staphylococcus aureus fue la bacteria causal más frecuente de contaminación de las agujas utilizadas siendo el Bacillus subtilis el principal contaminante de agujas no utilizadas. El uso de profilaxis antibiótica previa al procedimiento reduce significativamente el inóculo bacteriano. Se requieren futuros estudios con ampliación de la muestra para controlar posibles fallas técnicas.

Purpose: to evaluate the prevalence of bacterial contamination in needles used for intravitreal injections of Ranibizumab, analyze conjunctival flora, identify the most common microorganism present in used needles and evaluate the efficacy of antibiotic prophylaxis in reducing conjunctival flora at the time of the procedure. Methods: a case series study. Patients of the Fundación Oftalmológica Nacional, who underwent intravitreal injections of Ranibizumab between April 6 and September 28, 2010. Ages 44 to 91 years. The used needle, an unused control needle and a conjunctival scraping from the inferior fornix were inoculated in tryptone soy broth at 37°C for 5 days. Results: 150 cultures were obtained from 50 patients.44 patients had consistent results (negative control needle) and were included in the analysis. Staphylococcus aureus, Staphylococcus epidermidis, Bacillus subtilis, Difteroides, y Staphylococcus haemolyticus were identified. Staphylococcus aureus was the most frequent contaminant of the used needles (10%), followed by Difteroides (4%) and Bacillus subtilis (4%). Difteroides, Bacillus subtilis and Staphylococcus aureus were found in unused needles. Staphylococcus haemolyticus, aureus, epidermidis and Difteroides were found in the conjunctival samples. 61.4% had negative cultures. Conclusion: Staphylococcus aureus was the most frequent contaminant of used needles and Bacillus subtilis of control needles. The use of antibiotic profilaxis previous to the procedure, significantly reduces the bacterial inoculums. Futures studies are required to increase sample size and control technical errors.

Infection control to avoid surgical site infection

Infection control is a discipline that applies epidemiologic and scientific principles and statistical analysis to prevent or reduce rates of nosocomial infections. Effective infection control programs proved to reduce the rates of nosocomial infections and to be cost-effective. It is a key component of the broader discipline of hospital epidemiology. As an example, the anesthesia team acts every day in a highly complex and high risk environment for the transmission of pathogenic organisms and induction of infectious complication. In order to achieve the main goal of preventing or reducing the risk of hospital-acquired infections, a hospital epidemiology program should have the following oversight functions and responsibilities: Surveillance, either hospital-wide or targeted Education about prevention of infections. Outbreak investigations cleaning, disinfection and sterilization of equipments and disposal of infectious waste hospital employee health, specifically after exposure to either blood-borne or respiratory pathogens, Review of antibiotic utilization and its relationship to local antibiotic resistance patterns, Prevention of infections due to percutaneous intravascular devices. Development of infection control policies and procedures oversight on the use of new products that directly or indirectly relate to the risk of nosocomial infections

Experiencia en el abordaje de pacientes con profilaxis posexposición no ocupacional al VIH / Experience with patients seeking post-exposure prophylaxis against HIV after non-occupational accidents

Introducción: El objetivo es analizar los datos epidemiológicos y las conductas sexuales de una cohorte de adultos sanos que recibieron profilaxis posexposición no ocupacional (PPENO) al VIH. Métodos: Se analizaron todos los individuos que concurrieron a la Unidad de Consultorios Externos del Hospital de Enfermedades Infecciosas F. J. Muñiz y que requirieron PPENO desde diciembre de 2004 a diciembre de 2008. Se evaluaron los datos demográficos, el tipo de exposición, el conocimiento de la fuente y el uso de preservativo. Se realizaron pruebas no paramétricas; se definió el nivel de significación como p = 0.05. Cuando fue posible, se analizó el riesgo relativo y los odds ratios. Resultados: Se asistieron 1318 personas, 499 mujeres, con un promedio de edad de 30.4 años mediana: 28.0. Tipo de exposición: sexual: 1054 (80.0%), sangre: 247 (18.7%), sexual y sanguínea: 14 (1.1%), sin datos: 3 (0.2%). No se encontraron diferencias estadísticamente significativas entre el sexo y el tipo de exposición, ni entre la edad y el tipo de exposición. Se conocía al individuo fuente en 413 casos (31.3%); no lo conocían 897 (68.1%); sin datos: 8 (0.6%). El conocimiento de la fuente fue mayor en las mujeres (35.6%). El promedio de edad fue mayor entre aquellos que conocían la fuente (31.3 años) en comparación con los que no la conocían (28.8). Usaron preservativos 859 casos (65.2%). Su empleo fue mayor entre hombres que no conocían la fuente y entre aquellos de mayor edad; sin embargo, la mayor edad no estuvo necesariamente asociada con el uso de preservativo. El tiempo medio desde la exposición hasta la consulta fue de 1.9 día, sin cambios durante el período estudiado. No se encontraron diferencias estadísticamente significativas en el tiempo entre la exposición accidental y la consulta en relación con el sexo o con la edad.

Postoperative wound infections after minor surgery: incidence and some associated risk factors

To determine the incidence of and some associated risk factors for surgical wound infections after minor surgery. Prospective cohort study included patients presenting for minor surgery at surgical clinics and offices, surgery departments at Al-Hussein and Bab El-Shaarria hospitals, Al-Azhar University, Cairo, Egypt. The study included 428 eligible patients. Relevant data were collected from participated patients using a pre-designed questionnaire. The included patients were assessed for post-operative wound infection. Overall incidence of postoperative wound infection is calculated with its 95% confidence interval. Multivariate logistic regression analyses were done to calculate the risk of postoperative wound infection with the various studied factors. The overall incidence of wound infection was occurred in 37 of the studied 428 patients [8.6%; 95% CI, 3.5%-13.8%]. Excisions from thigh [Relative risk [RR] = 2.2; 95% confidence interval [CI] = 1.3-3.6], excision of lipoma [RR= 2.2; 95% CI= 1.3-3.4] or biopsy of squamous cell carcinoma [1.8; 95% CI= 1.2-2.6], and diabetes [RR= 1.8; 95% 1.4-2.2] were independent risk factors for wound infection following minor surgery carried out in surgical clinics and offices. No risk difference was observed regarding the method of wound management. Our results indicate the high-risk groups for wound infection following minor surgery, such as people with diabetes and those undergoing excision of a non-melanocytic skin cancer or excision from a lower limb. Recognition of these groups could encourage more judicial use of prophylactic antibiotics and use of other interventions, including operating in the theatre, aimed at reducing infection rates

Estudo descritivo sobre a antibioticoprofilaxia na rupturaprematura pré-termo de membranas / Perinatal results of antibioticprophyxalis with erythromycin in preterm premature rupture of the membranes

Objetivo: avaliar os resultados perinatais do uso profilático de estearato de eritromicina nas pacientesinternadas na unidade de gestação alto risco da Maternidade Carmela Dutra (MCD), Florianópolis–SC, com diagnóstico de ruptura prematura pré-termo de membranas (RPM). Métodos: estudo descritivo com análise de todas as pacientes internadas com o diagnóstico de RPM e com idade gestacional entre 20 semanas e 33 semanas e cinco dias. Foram excluídas da pesquisa gestantes com históriade hipersensibilidade à eritromicina, com sinais clínicos e/ou laboratoriais de corioamnionite, que estavam emtrabalho de parto ou que faziam uso de antibióticos no momento da internação. A amostra obtida entre 1º de abril de 2007 e 15 de maio de 2008 foi de 22 pacientes. Resultados e conclusões: o tempo médio de latência foi de 12 dias. Não houve casos confirmados decorioamnionite. Uma (4,54%) gestante desenvolveu quadro de endometrite puerperal. Não houve óbitos maternos. Dois (9,09%) recém-nascidos desenvolveram sepse. A taxa de óbito neonatal foi de 13,63%. Apesarda nossa pequena casuística, o uso de eritromicina nas pacientes com RPM parece estar associado a umadiminuição na taxa de corioamnionite.

Objective: The purposes of this study were to evaluate perinatal results of the prophylactic use of erythromycin to patients admitted in the high-riskgestation unit at Carmela Dutra Maternity Hospital, Florianópolis – SC with preterm premature rupture ofmembranes (PROM). Methods: We performed a descriptive analysis ofall patients with PROM and gestational age between 20 weeks and 33 weeks plus 5 days. Patients with erythromycin allergy, with chorioamnionitis signs orwomen who already being prescribed antibiotics were excluded from this study. Enrolment was from April 1,2007, until May 15, 2008. Twenty-two women had been followed up in this study. Results and Conclusions: The medium latency period was 12 days. There was not confirmed chorioamnionitis case. The occurrence of endometritis was 4,54%. There was not maternal death. The occurrence of neonatal sepsis was 9,09% and theoccurrence of neonatal deaths was 13,63%. Despite our small casuistry, the prophylactic use of erythromycinseems to reduce the chorioamnionitis rate.

Uso de cefotaxime en la sala de neumología en el Hospital Fernando Vélez Páiz del 1 de enero al 30 de diciembre del 2006 / Use of cefotaxime in the room of neumología in the Hospital Fernando Vélez Páiz of the 1 of January to the 30 of December of the 2006

El presente trabajo se realizó en el Hospital Dr. Fernando Velez Páiz, en el período del 1 de enero al 3o de diciembre 2006, en el que se identificó el uso de Cefotaxima en las salas de Neumología. Es un estudio de utilización de medicamentos de tipo prescripción- indicación, que contó con un universo de 51 pacientes y una muestra no probalilística de 40 pacientes. Predominó el grupo etareo de los 29 días a 11 meses con 27 casos. En cuanto a procedencia 28 pertenecían al área urbana. La mayor parte de los niños que recibieron Cefotaxime fueron del sexo masculino. El estado nutricional de los niños bajo estudio 21 tenian desnutrición de I grado. El criterio clínico que predominó fueron la tos y la fiebre, en pacientes con neumonía, en su mayor parte no se específico el criterio radiológico, siendo la BHC alterado en la mayoría de los pacientes. El esquema de tratamiento previomás usado de forma ambulatoría fue la amoxicilina y como esquema de primera línea hospitalaria fue la Ampicilina + gentamicina y penicilina cristalina en un mismo porcentaje...

Current status of prophylactic use of antimicrobial agents for caesarean section in a tertiary care teaching hospital in eastern Nepal.

A prospective assessment of the current status of prophylactic use of antimicrobial agents (AMAs) for caesarean section deliveries at BPKIHS, Dharan, Nepal was done. Data was collected by systemic random sampling of 349 in patient case sheets. The prevalence of use of ampicillin either alone or in combination with metronidazole was noted in both the elective and non-elective groups, either in the hospital or at discharge, while only 7.0-9.0% of patients receivedAMAs other than ampicillin. Ampicillin has been reported to be an effective AMA in reducing post-partum endometritis and our observation also corroborates with this finding.

Prescribing regimes of prophylactic antibiotic used in different surgeries.

AIM AND OBJECTIVE: The main objective was to study the different types of regimen of prophylactic antibiotic in different surgeries in hospitals of western region, particularly, Pokhara valley and the hospitals were Western Regional Hospital (WRH) and Manipal Teaching Hospital (MTH). METHODOLOGY: A descriptive, quantitative, retrospective study were used to evaluate the patients undergone surgery in the year 2059 BS (15th April 2002-14th April 2003). The total of 950 patients, 450 from WRH and 500 from MTH were taken from the medical record for the study. Data about different types of prophylactic antibiotic regimen was collected. CONCLUSION: The most common surgery in MTH is dilatation and curettage (D and C) and in WRH is caesarean section (CS). In both hospitals Ampicillin+Cloxacillin was the most commonly used regimen, 12.4% in WRH and 34% in MTH. In WRH ciprofloxacin and cefotaxime was also used by 12.4%. Ciprofloxacin and gentamicin (12%) combination was the third commonly used regimen in WRH where as ciprofloxacin (28.4%), Ampi+Cloxa and gentamicin (22.4%) in MTH.

El dentista mexicano y la recomendación de la Asociación Americana del Corazón para la prevención de la endocarditis bacteriana / The Mexican dentist and the recommendation by th American Heart Association for the prevention of bacterial endocarditis

Con el objetivo de explorar entre los cirujanos dentistas el conocimiento de la recomendación de la Asociación Americana del Corazón (AHA) para la prevención de endocarditis bacteriana (EB), se circuló un cuestinario en una muestra no probabilística de 674 dentistas en la ciudad de México y su zona metropolitana. Resultados: doscientos ochenta y dos dentistas (41.8 por ciento) reportan haber atendido a pacientes con antecedentes de fiebre reumática. El antibiótica reportado como primera opción fue la penicilina G (43 por ciento), seguido de la amoxicilina (33.7 por ciento). Como opción para los pacientes alérgicos a la penicilina, los dentistas que contestaron el cuestionario eigieron la eritromicina en un 85 por ciento y el 11.7 por ciento clindamicina. En cuanto al tiempo previo a la cita que se tiene que administrar el antibiótico, el 46 por ciento lo hace con 48 horas de anticipación, y el 14.5 por ciento una hora antes. La actividad clínica que más se asoció a la necesidad de cobertura antibiótica fue la exodoncia (85.9 por ciento). Conclusiones: los resultados anteriores sugieren que hay un desconocimiento de la última recomendación de la AHA entre los dentistas que participaron en el estudio, por lo que se deben buscar estrategias de actualización que permitan prevenir la posible aparición de EB en los pacientes de riesgo que acuden al consultorio dental

Antibioprofiláxis en cirugías orales / Antibioprophylaxis in oral surgeries

En el pabellón odontológico ambulatorio de la Clínica Odontológica Docente Asistencial de la Universidad de La Frontera, Temuco, se realizaron 90 intervenciones quirúrgicas odontológicas, de carácter electivo, durante el año 2001. Con el objetivo de conocer el uso de Antibioticoterapia, se revisaron la totalidad de las fichas clínicas de pabellón y fichas de control. De las 90 cirugías estudiadas, en 61 casos (68 por ciento), no se usó ningún tipo de terapia antibiótica. En 29 casos (32 por ciento), se utilizó terapia antibiótica. Sin embargo los esquemas encontrados tienen relación, preferentemente, con terapias antibióticas más que con las utilización de la profilaxis con antimicrobianos perioperatoria (P.A.P). Sólo en tres casos se usó este procedimiento. El antimicrobiano más usado (93 por ciento) fue la amoxicilina. En ningún paciente se presentó infección post-operatoria. Se puede concluir que el uso de terapia antibiótica en cirugía odontológica ambulatoria de herida operatoria limpia, salvo en caso de cirugía de implante, es discutible. Se observa un probable desconocimiento de la P.A.P., pues los antibióticos se indican con esquemas terapéuticos muy variados y no profilácticos, con lo que se aumentaría la resistencia bacteriana.

Study of drug utilization pattern in dental OPD at tertiary care teaching hospital.

Irrational prescribing is a global phenomenon. The objective of the study was to find out the prescribing practices of dental prescribers in a tertiary care teaching hospital with special emphasis on the utilization of antimicrobial agents. A prospective study was conducted in the month of March 2000. A total of 491 prescriptions were collected randomly. Prescribing pattern was analyzed using WHO basic drug indicators. The average number of drugs for prescription was 2.4. 78.8% of all prescriptions contained antimicrobial agents. It was most commonly prescribed (40.37%) group of drugs followed by anti-inflammatory and analgesics (33.8%). Fixed dose combination of ampicillin and cloxacillin was most commonly prescribed antimicrobial agents. Prophylactic use of AMA (78%) was more than therapeutic purpose (21.9%). Prophylactic use of antimicrobial agents was irrational in all the cases as duration for the use of antimicrobial agents was 5.1 +/- 0.5 days. Fixed dose combinations (45%), drugs by brand name (98.5%) were frequently used. Drug prescribed from Essential Drug List was maximum when one drug was prescribed. Results indicate that there is a scope for improving prescribing habits and minimizing the use of antimicrobial agents. This could be facilitated by periodic education to the prescribers.

Role of intrapartum antibiotics in prevention of vertical transmission of neonatal sepsis.

The present study evaluates the role of prophylactic intrapartum antibiotics in the prevention of neonatal sepsis. Labour and delivery characteristics of 1478 women delivering at the Nehru Hospital, PGIMER, Chandigarh were recorded. Intrapartum antibiotics (ampicillin, with or without gentamycin) were given to 69 per cent women. The neonatal sepsis rate was 1.56 per cent. This was not significantly lower in the women who received intrapartum antibiotics (1.47 vs 1.75%). Though there was a lowering of neonatal sepsis rate with intrapartum antibiotic administration when the duration of labour was more than 12 h (1.67 vs 3.09%), duration of ruptured membranes was more than 6 h (1.93 vs 3.81%) and number of pelvic examination was 3 or more (1.63 vs 4.54%), it was not statistically significant. It was concluded that intrapartum antibiotics as per the existing protocol did not prevent neonatal sepsis.

Estudio ORACLE: protocolo y estado actual de la investigación en la Argentina / ORACLE study: protocol and present status of the investigation in Argentine

ORACLE es una investigación aleatorizada factorial pragmática multicéntrica, dirigida desde la Universidad de Leicester (Reino Unido), cuyo objetivo es verificar el rol de la antibióticoterapia (eritromicina y/o augmentina y/o placebo) en la amenaza de parto prematuro (APP), con o sin rotura prematura de membranas (RPM). Los puntos finales principales son mortalidad perinatal y morbilidad neonatal severa. El tamaño muestral propuesto es de 10.000 casos. Participan 164 maternidades de 16 países y se llevan incluidos 7.364 pacientes. Argentina, que inició su gestión en agosto de 1997, a marzo de 1999 lleva incluidos 762 pacientes, reclutados entre las 9 maternidades participantes, sitas en Buenos Aires, provincia de Buenos Aires y Salta. Dos de ellas, figuran 2º y 3º en la lista de hospitales con mayor índice de reclutamiento en el mundo. El 88 por ciento de las ingresadas presentó APP y el 12 por ciento, RPM. Ambas situaciones se combinaron en el 8 por ciento de ellas. La mediana de la edad gestacional al ingreso es 32 semanas (cuartilos: 29 y 34). El 82,6 por ciento ya finalizó su participación y sólo hay un 2 por ciento de pérdidas de seguimiento. El 58 por ciento de los nacimientos ocurrió al término. La mediana de peso al nacer es 2.870 g (cuartilos 2.250 y 3.250). El 27 por ciento requirió UTI y la mortalidad perinatal es 3,6 por ciento. No se han registrado efectos adversos fetoneonatales atribuibles a las medicaciones del estudio. Los efectos adversos maternos suman 14 casos y han sido los habituales ante el consumo de antibióticos.

Antibioticoprofilaxis en las colecistectomías: ¿cuál es la mejor alternativa? / Antibiotic prophylaxis in cholecystectomy

Se estudió microbiologicamente el líquido vesicular (LV) de 132 pacientes litiásicos sometidos a colecistectomía. Hubo predominio del sexo femenino (66 por ciento). La presencia de infección fue predominante en aquellos pacientes de mayor edad. Se recuperaron microorganismos en 34 pacientes (20 por ciento); en su gran mayoría fueron aislamientos monomicrobianos (71 por ciento). En la mayoría de los casos el examen directo (Gram) predijo los cultivos positivos. Esto es muy importante, ya que su correlación con los cultivos es alta, por lo que constituye un elemento de guía para la elección racional de la terapia con antibióticos (ATB), sugiere el tipo de ATB, selecciona a los pacientes susceptibles al mismo, ya sea para su prolongación o la transformación de la profilaxis en tratamiento