Browsing by Subject "Prophylaxis"

Sort by: Order: Results:

Now showing items 1-7 of 7
  • Välkki, Kirsi J; Thomson, Katariina H; Grönthal, Thomas S C; Junnila, Jouni J T; Rantala, Merja H J; Laitinen-Vapaavuori, Outi M; Mölsä, Sari H (BioMed Central, 2020)
    Abstract Background Surgical site infections (SSI) are associated with increased morbidity and mortality. To lower the incidence of SSI, antimicrobial prophylaxis is given 30–60 min before certain types of surgeries in both human and veterinary patients. However, due to the increasing concern of antimicrobial resistance, the benefit of antimicrobial prophylaxis in clean orthopaedic and neurosurgeries warrants investigation. The aims of this retrospective cross-sectional study were to review the rate of SSI and evaluate the compliance with antimicrobial guidelines in dogs at a veterinary teaching hospital in 2012–2016. In addition, possible risk factors for SSI were assessed. Results Nearly all dogs (377/406; 92.9%) received antimicrobial prophylaxis. Twenty-nine dogs (7.1%) did not receive any antimicrobials and only four (1.1%) received postoperative antimicrobials. The compliance with in-house and national protocols was excellent regarding the choice of prophylactic antimicrobial (cefazolin), but there was room for improvement in the timing of prophylaxis administration. Follow-up data was available for 89.4% (363/406) of the dogs. Mean follow-up time was 464 days (range: 3–2600 days). The overall SSI rate was 6.3%: in orthopaedic surgeries it was 6.7%, and in neurosurgeries it was 4.2%. The lowest SSI rates (0%) were seen in extracapsular repair of cranial cruciate ligament rupture, ulnar ostectomy, femoral head and neck excision, arthrotomy and coxofemoral luxation repair. The highest SSI rate (25.0%) was seen in arthrodesis. Omission of antimicrobials did not increase the risk for SSI (P = 0.56; OR 1.7; CI95% 0.4–5.0). Several risk factors for SSI were identified, including methicillin-resistant Staphylococcus pseudintermedius carriage (P = 0.02; OR 9.0; CI95% 1.4–57.9) and higher body temperature (P = 0.03; OR 1.69; CI95% 1.0–2.7; mean difference + 0.4 °C compared to dogs without SSI). Conclusions Antimicrobial prophylaxis without postoperative antimicrobials is sufficient to maintain the overall rate of SSI at a level similar to published data in canine clean orthopedic and neurosurgeries.
  • Välkki, Kirsi Johanna; Thomson, Katariina Hanne; Grönthal, Thomas Sven Christer; Junnila, Jouni Juho Tapio; Rantala, Merja Hilma Johanna; Laitinen-Vapaavuori, Outi Maria; Mölsä, Sari Helena (2020)
    Background Surgical site infections (SSI) are associated with increased morbidity and mortality. To lower the incidence of SSI, antimicrobial prophylaxis is given 30-60 min before certain types of surgeries in both human and veterinary patients. However, due to the increasing concern of antimicrobial resistance, the benefit of antimicrobial prophylaxis in clean orthopaedic and neurosurgeries warrants investigation. The aims of this retrospective cross-sectional study were to review the rate of SSI and evaluate the compliance with antimicrobial guidelines in dogs at a veterinary teaching hospital in 2012-2016. In addition, possible risk factors for SSI were assessed. Results Nearly all dogs (377/406; 92.9%) received antimicrobial prophylaxis. Twenty-nine dogs (7.1%) did not receive any antimicrobials and only four (1.1%) received postoperative antimicrobials. The compliance with in-house and national protocols was excellent regarding the choice of prophylactic antimicrobial (cefazolin), but there was room for improvement in the timing of prophylaxis administration. Follow-up data was available for 89.4% (363/406) of the dogs. Mean follow-up time was 464 days (range: 3-2600 days). The overall SSI rate was 6.3%: in orthopaedic surgeries it was 6.7%, and in neurosurgeries it was 4.2%. The lowest SSI rates (0%) were seen in extracapsular repair of cranial cruciate ligament rupture, ulnar ostectomy, femoral head and neck excision, arthrotomy and coxofemoral luxation repair. The highest SSI rate (25.0%) was seen in arthrodesis. Omission of antimicrobials did not increase the risk for SSI (P = 0.56; OR 1.7; CI(95%)0.4-5.0). Several risk factors for SSI were identified, including methicillin-resistantStaphylococcus pseudintermediuscarriage (P = 0.02; OR 9.0; CI(95%)1.4-57.9) and higher body temperature (P = 0.03; OR 1.69; CI(95%)1.0-2.7; mean difference + 0.4 degrees C compared to dogs without SSI). Conclusions Antimicrobial prophylaxis without postoperative antimicrobials is sufficient to maintain the overall rate of SSI at a level similar to published data in canine clean orthopedic and neurosurgeries.
  • Korpela, Taija; Cardenas-Jaen, Karina; Archibugi, Livia; Poropat, Goran; Maisonneuve, Patrick; Arcidiacono, Paolo Giorgio; De Pretis, Nicolo; Löhr, Matthias; Capurso, Gabriele; de-Madaria, Enrique (2018)
    Background: Acute pancreatitis (AP) is the most common complication after endoscopic retrograde cholangiopancreatography (ERCP). Statins have been traditionally associated to an increased risk of AP, however, recent evidence suggests that statins may have a protective role against this disease. Aims: Our primary aim is to investigate whether the use of statins has a protective effect against post-ERCP pancreatitis (PEP). Secondary outcomes are: to evaluate the effect of other drugs on the incidence of PEP; to ascertain the relationship between the use of statins and the severity of PEP; and to evaluate the effect of other risk and protective factors on the incidence of PEP. Methods: STARK is an international multicenter prospective cohort study. Centers from Spain, Italy, Croatia, Finland and Sweden joined this study. The total sample size will include about 1016 patients, which was based on assuming a 5% incidence of PEP among non-statin (NSt) users, a 1-3 ratio of statin (St) and NSt consumers respectively, a 70% decrease in PEP among St consumers, an alpha-error of 0.05 and beta-error of 0.20. All patients aged >18 years scheduled for ERCP will be offered to enter the study. Discussion: STARK study will ascertain whether statins, a safe, widely used and inexpensive drug, can modify the incidence of PEP. (C) 2018 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
  • Kaila, Marianne; Marjoniemi, Jasmine; Nokireki, Tiina (2019)
    Seventy-two canine serum samples were analyzed for post-vaccination serum titers of rabies antibodies. The samples were divided into two groups: Group 1 dogs (n = 36) were imported dogs from the Russian Federation (n = 31) or Romania (n = 5), with a mean serum antibody titer value of 1.54 IU/mL. Group 2 dogs (n = 36) were Finnish dogs vaccinated in Finland, with a mean titer of 4.19 IU/mL. Altogether, 14 (39%) dogs (CI 95% 23–56) were without detectable antibodies (≤ 0.1 IU/mL) in Group 1, whereas in Group 2, all dogs had an antibody titer greater than 0.1 IU/mL. A statistically significant difference was observed between these groups when comparing the proportions of dogs with antibody levels less than or exceeding 0.5 IU/mL. In Group 1, 19 out of the 36 dogs (CI 95% 36–70) had serum titer values 
  • Kaila, Marianne; Marjoniemi, Jasmine; Nokireki, Tiina (BioMed Central, 2019)
    Abstract Seventy-two canine serum samples were analyzed for post-vaccination serum titers of rabies antibodies. The samples were divided into two groups: Group 1 dogs (n = 36) were imported dogs from the Russian Federation (n = 31) or Romania (n = 5), with a mean serum antibody titer value of 1.54 IU/mL. Group 2 dogs (n = 36) were Finnish dogs vaccinated in Finland, with a mean titer of 4.19 IU/mL. Altogether, 14 (39%) dogs (CI 95% 23–56) were without detectable antibodies (≤ 0.1 IU/mL) in Group 1, whereas in Group 2, all dogs had an antibody titer greater than 0.1 IU/mL. A statistically significant difference was observed between these groups when comparing the proportions of dogs with antibody levels less than or exceeding 0.5 IU/mL. In Group 1, 19 out of the 36 dogs (CI 95% 36–70) had serum titer values < 0.5 IU/mL, while in Group 2, only 2 dogs had serum titer values < 0.5 IU/mL. Despite the small sample size, this raises concern over the imported dogs having insufficient antibody levels required for international travel and implies that these dogs had perhaps not been vaccinated, even though they had documentation of vaccination upon arrival.
  • Kaila, M.; Marjoniemi, I.; Nokireki, T. (2019)
    Acta Veterinaria Scandinavica 2019: Vol. 61, No. 15
    Seventy-two canine serum samples were analyzed for post-vaccination serum titers of rabies antibodies. The samples were divided into two groups: Group 1 dogs (n = 36) were imported dogs from the Russian Federation (n = 31) or Romania (n = 5), with a mean serum antibody titer value of 1.54 IU/mL. Group 2 dogs (n = 36) were Finnish dogs vaccinated in Finland, with a mean titer of 4.19 IU/mL. Altogether, 14 (39%) dogs (CI 95% 23–56) were without detectable antibodies (≤ 0.1 IU/mL) in Group 1, whereas in Group 2, all dogs had an antibody titer greater than 0.1 IU/mL. A statistically significant difference was observed between these groups when comparing the proportions of dogs with antibody levels less than or exceeding 0.5 IU/mL. In Group 1, 19 out of the 36 dogs (CI 95% 36–70) had serum titer values < 0.5 IU/mL, while in Group 2, only 2 dogs had serum titer values < 0.5 IU/mL. Despite the small sample size, this raises concern over the imported dogs having insufficient antibody levels required for international travel and implies that these dogs had perhaps not been vaccinated, even though they had documentation of vaccination upon arrival.
  • Vander Poorten, Vincent; Uyttebroek, Saartje; Robbins, K. Thomas; Rodrigo, Juan P.; de Bree, Remco; Laenen, Annouschka; Saba, Nabil F.; Suarez, Carlos; Mäkitie, Antti; Rinaldo, Alessandra; Ferlito, Alfio (2020)
    BackgroundThe optimal evidence-based prophylactic antibiotic regimen for surgical site infections following major head and neck surgery remains a matter of debate.MethodsMedline, Cochrane, and Embase were searched for the current best evidence. Retrieved manuscripts were screened according to the PRISMA guidelines. Included studies dealt with patients over 18 years of age that underwent clean-contaminated head and neck surgery (P) and compared the effect of an intervention, perioperative administration of different antibiotic regimens for a variable duration (I), with control groups receiving placebo, another antibiotic regimen, or the same antibiotic for a different postoperative duration (C), on surgical site infection rate as primary outcome (O) (PICO model). A systematic review was performed, and a selected group of trials investigating a similar research question was subjected to a random-effects model meta-analysis.ResultsThirty-nine studies were included in the systematic review. Compared with placebo, cefazolin, ampicillin-sulbactam, and amoxicillin-clavulanate were the most efficient agents. Benzylpenicillin and clindamycin were clearly less effective. Fifteen studies compared short- to long-term prophylaxis; treatment for more than 48 h did not further reduce wound infections. Meta-analysis of five clinical trials including 4336 patients, where clindamycin was compared with ampicillin-sulbactam, implied an increased infection rate for clindamycin-treated patients (OR=2.73, 95% CI 1.50-4.97, p=0.001).ConclusionIn clean-contaminated head and neck surgery, cefazolin, amoxicillin-clavulanate, and ampicillin-sulbactam for 24-48 h after surgery were associated with the highest prevention rate of surgical site infection.