OBJECTIVE We studied the prevalence of nasopharyngeal (NP) carriage, antimicrobial susceptibilities, and serotypes of Streptococcus pneumoniae (SP) in children with sickle cell disease (SCD) in the Mid-South. In addition, we examined risk factors for NP carriage of penicillin-resistant SP (PRSP). STUDY DESIGN Between July 1994 and December 1995, we obtained NP cultures from 312 children with ...

The article by Hughes et al. [1] from the Pediatric AIDS Clinical Trials Group describing a randomized comparison of daily administration of trimethoprim-sulfamethoxazole (TMP-SMZ) and ato-vaquone-azithromycin brings into focus a number of interesting issues related to HIV infections worldwide, as well as the daily use of prophylactic antimicrobials in general. The trial was halted early, befor...

CLINICAL QUESTION Based on the grade of open fracture, which antibiotic should be selected for antimicrobial prophylaxis, and what is the optimal timing and duration of administration? RESULTS For Grade I and II open fractures, a first-generation cephalosporin (eg, cefazolin) should be administered within 3 hours of initial injury and be continued for 24 hours after initial injury. Grade III ...

See Articles page 381 In The Lancet Infectious Diseases, Hiroshi Imamura and colleagues report data from a randomised controlled trial of antimicrobial prophylaxis in patients having distal gastrectomy for cancer. Patients were randomly assigned to receive 1 g of cefazolin before the incision only or an additional dose once after closure and twice daily for 2 days after surgery. The rates of su...

In a prospective, double-blind, randomized study of patients subjected to gastric surgery, parenteral cefazolin begun before operation significantly reduced the would infection rate. Infection developed only when incisional contamination occurred during operation and either when the antibiotic was not present in the tissues of the wound at the time of inoculation or when the offending bacteria ...

BACKGROUND The systemic antimicrobial prophylaxis is the standard treatment in the prevention of osteomyelitis after open fractures, with topical application of antimicrobials as an alternative due to their high concentrations at the site of the fracture, low systemic concentrations and fewer side effects. OBJECTIVES This study aimed to evaluate the effectiveness of prophylaxis of osteomyelit...

BACKGROUND There is still wide variability in surgical antimicrobial prophylaxis (SAP) practice by different surgical teams and specialties, with potential impact on adverse events and the emergence of antibiotic resistance. METHODS We assessed SAP appropriateness in a regional prospective multicenter study on the basis of the agreement of the Surgical Care Improvement Project indicators (SCI...

Objective: Drug utilization pattern identifies the problems that arise from the drug usage in health care delivery system and highlights the current approaches to the rational use of drugs. The present study evaluates the utilization pattern of antimicrobial agents in hospital deliveries of different setups. Methodology: Two hundred hospital deliveries from a government hospital GroupI (G-I) an...

BACKGROUND Intensivists and cardiothoracic surgeons are commonly worried about surgical site infections (SSIs) due to increasing length of stay (LOS), costs and mortality. The antimicrobial prophylaxis is one of the most important tools in the prevention of SSIs. The objective of this study was to investigate the relationship between the timing of antimicrobial prophylaxis administration and th...

BACKGROUND The goal of antibiotic prophylaxis is not to sterilize the operative field, but to minimize the perioperative bacterial load to the level that will not result in clinical infection. Patient-related risk factors, such as poor nutritional status, smoking, diabetes and impaired immune system, and nature of the surgery should be reviewed when considering prophylactic use of antibiotics. ...