Bone and joint perfusion with antibiotics in the treatment of experimental staphylococcal infection in rabbits.
Explore the source record for details and available documents.
Animals↗
Biomedical subjects
T Sacks
Publications and source records attributed to T Sacks.
Risk factors for post-operative wound infection in cardiac surgery patients.
In a prospective study of 372 patients undergoing cardiac surgery, we evaluated the relative contribution of host factors and patient care variables to the risk of post-operative wound infection. Host factors studied were age, sex, country of origin, the diagnosis for which the operation was performed and, for coronary artery by-pass operations, the functional cardiac status according to modified New York Heart Association criteria. The performance of more than one operation during a single admission carried the highest risk for infection, followed by a coronary artery by-pass operation lasting for more than six hours or performed on patients 65 years or older. In patients undergoing coronary artery by-pass surgery, host factors (age and cardiac function) were associated with infections in the chest wound, while the length of the operation was found to affect the occurrence of infections at the "donor" site.
Adolescent↗
Multivariate analysis of determinants of postoperative wound infection: a possible basis for intervention.
Multivariate analysis of variables hypothetically associated with the development of postoperative wound infection was attempted with use of large groups of patients undergoing certain surgical procedures over periods of 12-36 months. The data were obtained through prospective surveillance by specially trained nurse-epidemiologists. For patients who had colon surgery (n=261), the multivariate analysis showed that only four variables were independently associated with postoperative wound infection: more than one operation during a single episode of hospitalization (adjusted odds ratio, 7.3); Arab ethnicity (adjusted odds ratio, 6.1); prophylaxis according to the recommended protocol not given (adjusted odds ratio, 2.4); and opening of a colostomy as the specific operation (adjusted odds ratio, 2.3). Of all the variables analyzed, more than one operation during an admission was consistently associated with the highest risk of infection in patients who had cardiac and neurosurgery as well as colon surgery. On the other hand, a traditional risk factor, e.g., the presence of drains at the site of the operation, was not found to be independently associated with an increased risk of infection in any of the groups tested. This type of analysis is essential to facilitate the introduction of a more meaningful program for intervention based on proved rather than hypothetical risk factors
Analysis of Variance↗
Antibiotic use on the surgical services of two Jerusalem hospitals, as determined by surveillance and influenced by an intervention program.
The use of antimicrobial drugs on the surgical services of two hospitals in Jerusalem, Israel, was surveyed prospectively. At one hospital (C), the use of these drugs was controlled: at the other (N), the use was not controlled. At both hospitals the cephalosporins accounted for approximately 21% of the antimicrobial drug-group courses (AMDGCs), however, they accounted for only 11% of the antimicrobial days (AMDs) at C but 22% at N. Prophylaxis after surgical procedures accounted for the initiation of 36% and 33% of the AMDGCs at C and N, respectively. The geometric mean of the duration of prophylactic courses of drug therapy was 3.2 days at C and 3.9 days at N (P less than 0.01). Excessively prolonged prophylaxis accounted for approximately 61% (388 AMDs) of prophylactic use at N and 55% (646 AMDs) at C. At C the proportion of patients receiving prophylaxis in high-risk surgical operations increased from 39% to 97% after the introduction of protocols for prophylaxis, but the average quantity of antimicrobial drugs administered per patient decreased by 38%.
Adolescent↗
Social, behavioral, and practical factors affecting antibiotic use worldwide: report of Task Force 4.
In addressing its charge from the General Chairperson of this study, Task Force 4 decided to direct special attention to antibiotic use in developing nations because of the critical importance of the disease burden of bacterial infections in these regions of the world. The task force recognized the impact of respiratory and diarrheal diseases on morbidity and mortality among young children in developing nations. Another major concern was the potential for global spread of resistant strains. Emergence and spread of antibiotic-resistant bacteria is augmented in settings in which treatment may be inadequate because of socioeconomic constraints and where there is crowding and poor sanitation. Much of the information concerning the factors that govern antibiotic use in these countries is anecdotal. No two countries are identical in their use of antimicrobial agents, and patterns of use may differ greatly in regions within the same country. Efforts to improve the usage of antibiotics in developing countries must take into consideration the perception of health and disease of the populations, the availability of antibiotics, and the characteristics of the established systems of medical care.
Acute Disease↗