| 1. |
- Claesson, B E, et al.
(författare)
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Microflora of the gallbladder related to duration of acute cholecystitis
- 1986
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Ingår i: Surgery Gynecology and Obstetrics. - 0039-6087. ; 162:6, s. 531-535
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Tidskriftsartikel (refereegranskat)abstract
- The microflora of the bile and wall of the gallbladder was prospectively investigated in 104 nonselected consecutive patients treated with early cholecystectomy for acute cholecystitis after an average hospital stay of 1.8 days. The chief purpose was to relate the findings of cultures to duration of the illness. Special attention was paid to anaerobic isolation techniques. The cultures yielded 107 strains, representing 36 species, with overall agreement between four different sampling procedures. Aerobic gram-negative rods predominated, followed by streptococci and anaerobes (48, 31 and 15 per cent, respectively). The incidence of positive culture results (always greater than or equal to 10(6) colon forming units per milliliter) was 81 per cent among the patients who underwent operation within two days from the onset of symptoms and 50 to 65 per cent after longer preoperative intervals. The shorter interval was significantly more often associated with growth solely of anaerobes (p = 0.03). Postoperative sepsis was caused by biliary bacteria and not related to preoperative duration of illness. Appropriate perioperative antibiotic coverage significantly reduced sepsis--3 versus 20 per cent (p = 0.05).
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| 2. |
- Claesson, B E, et al.
(författare)
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Selective cefuroxime prophylaxis following colorectal surgery based on intra-operative dipslide culture
- 1986
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Ingår i: British Journal of Surgery. - : Oxford University Press (OUP). - 1365-2168 .- 0007-1323. ; 73:12, s. 953-957
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Tidskriftsartikel (refereegranskat)abstract
- The concept of a very limited effective period for prophylactic antibiotic action was challenged in a prospective, controlled and randomized study featuring a simplified method for assessing the degree of contamination in the operative field during colorectal surgery. The 226 patients were given 1 g metronidazole IV on induction of anaesthesia and 12 h postoperatively. Following standardized saline irrigation of the abdominal cavity, a uriculture dipslide was dipped in the residual fluid just before abdominal closure. The dipslide was incubated for 18 h, and colony counts of coliforms and Staphylococcus aureus were made. The number of colony-forming units (CFU) was classified as 0, 1-4 or greater than or equal to 5 (n = 123, 33 and 70). The patients with CFU greater than or equal to 5 were randomized to receive cefuroxime (1.5 g IV/8 h for 2 days) or no more antibiotics. In the patients given only metronidazole, the incidence of postoperative infections rose with the colony counts (5.7, 9.1 and 41.2 per cent with CFU 0, 1-4 and greater than or equal to 5). Addition of cefuroxime reduced the 41.2 per cent infection rate to 8.3 per cent (P = 0.003). The method thus identified a high-risk group in which a short postoperative course of cefuroxime significantly lowered the rate of sepsis.
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| 3. |
- Mätzsch, Thomas, et al.
(författare)
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Vergleich von Indometacin und Ketobemidon als Analgetikum bei akuter Cholecystitis
- 1986
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Ingår i: Klinische Wochenschrift. - 0023-2173. ; 64:8, s. 353-356
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Tidskriftsartikel (refereegranskat)abstract
- In an open, randomized prospective clinical trial the analgesic effect of indomethacin and ketobemidon was compared in 67 patients with acute cholecystitis (28 received 5 mg ketobemidon and 39 received 50 mg indomethacin). Both drugs showed a good and significant pain relief, exhibiting no significant difference in the analgesic effect and no serious adverse reactions. It was concluded that indomethacin administered intravenously is an alternative to ketobemidon intravenously in the treatment of pain resulting from acute cholecystitis and may offer some advantages.
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