The prophylactic antibiotic puzzle.
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Anti-Bacterial Agents↗
Biomedical subjects
E P Dellinger
Publications and source records attributed to E P Dellinger.
Proposed definitions for diagnosis, severity scoring, stratification, and outcome for trials on intraabdominal infection. Joint Working Party of SIS North America and Europe.
Analysis of the experience with scientific studies on patients with secondary intraabdominal infection has revealed that problems of interpretation and comparability between studies exist as they relate to variable diagnostic criteria, unmeasured severity of disease, and unclear outcome measures. A consistent system of definitions has been developed to address these deficiencies. Intraabdominal infection is defined as clinical peritonitis requiring both operative and microbiological confirmation for proof of infection. The APACHE II system is proposed for grading the severity of the infection and for stratification of patient risk of mortality. Mortality and time until death, on one hand, and recovery and time until recovery, on the other, are proposed as the main outcome measures, both being independently and positively defined. It is anticipated that this system of minimum rules will produce studies that can be compared, hence, accelerating knowledge and understanding about intraabdominal infection and its best treatment.
Abscess↗
Antibiotic prophylaxis in trauma: penetrating abdominal injuries and open fractures.
Infection is an important cause of late morbidity and mortality following traumatic injury. As part of a coordinated treatment effort for the injured patient, preventive antibiotic use can reduce subsequent infectious complications. Available evidence supports the use of antibiotic(s) with activity against both aerobic and anaerobic enteric pathogens for patients with penetrating abdominal injuries and bowel penetration. Patients with open fractures benefit from the use of an antibiotic with activity against Staphylococcus aureus. Data on the ideal dose and duration of antibiotic administration in these situations are incomplete. It is likely that the best results will be obtained with early parenteral administration of large doses of the chosen antibiotic continuing for less than or equal to 24 hours. For injuries other than penetrating abdominal wounds and open fractures, definitive information is not available.
Abdominal Injuries↗
Use of op site as an occlusive dressing for total parenteral nutrition catheters.
A retrospective study of standard hyperalimentation catheter dressing compared to the use of Op Site has demonstrated that Op Site is cost and time effective and is efficacious for attaining a low catheter sepsis rate. It is easy for nursing personnel to apply and comfortable for the patients to wear. Op Site may be contraindicated in diaphoretic patients.
Adolescent↗