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Hiromitsu Takeyama - One of the best experts on this subject based on the ideXlab platform.
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Evaluation of the efficacy and safety of intravenous ciprofloxacin versus meropenem in the treatment of Postoperative Infection
Journal of Infection and Chemotherapy, 2012Co-Authors: Shinya Kusachi, Hiromitsu Takeyama, Keiji Mashita, Yoshinobu Sumiyama, Yoshiki Takahashi, Komei Kato, Shigeto Oda, Shinichi KobayashiAbstract:Therapeutic options for Postoperative Infection in gastrointestinal surgery are limited. To identify new treatment alternatives, the Japan Society for Surgical Infection conducted a multicenter prospective, randomized, controlled clinical trial comparing the efficacy of intravenous ciprofloxacin (CIP IV) and intravenous meropenem (MEM IV). Between July 2005 and May 2008, the trial recruited patients who developed Postoperative Infection or had suspected infectious systemic inflammatory response syndrome after elective clean-contaminated gastrointestinal surgery. All patients had received prophylactic Postoperative antibiotic treatment. Patients received either intravenous CIP IV 300 mg b.i.d. or MEM IV 500 mg b.i.d. A total of 205 patients from 31 institutions were enrolled. Of these, 101 were randomized to CIP IV and 104 to MEM IV. There were 100 and 102 in the intent-to-treat (ITT)/safety population and 75 and 77 in the per-protocol (PP) population. There was no significant difference between CIP IV and MEM IV in terms of clinical efficacy, bacteriological efficacy, incidence of adverse drug reactions, duration of antimicrobial treatment, or relapse/reactivation. Overall clinical success PP population) was high in both treatment groups: 85.3% (64/75) for CIP IV and 89.6% (69/77) for MEM IV, although the non-inferiority of CIP IV was not demonstrated (difference −4.3%, 95% CI −14.8, 6.2). In patients who had undergone upper gastrointestinal surgery, success was 88.5% (23/26) for CIP IV and 85.2% (23/27) for MEM IV. Intravenous ciprofloxacin is as effective as intravenous meropenem in the empiric therapy of Postoperative Infection after gastrointestinal surgery.
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A questionnaire survey on the theory of Postoperative Infection prophylaxis in urology
The Japanese journal of antibiotics, 2002Co-Authors: Nagao Shinagawa, Taiji Tsukamoto, Shigetomi Iwai, Tetsuro Matsumoto, Sadao Kamidono, Soichi Arakawa, Takashi Yokoyama, Yutaro Hayashi, Hiromi Kumon, Hiromitsu TakeyamaAbstract:A questionnaire survey on the theory of Postoperative Infection prophylaxis was conducted to obtain the consensus on perioperative antimicrobial use among urologists in Japan in the period from April to July 2000. Sixty-three of the 87 urologists replied, and the following consensus was obtained. An antimicrobial prophylaxis (AMP) agent should be chosen based on their efficacy against the pathogens expected to be contaminants, such as Escherichia coli, Staphylococcus spp., Klebsiella pneumoniae and Bacteroides fragilis group. Use an AMP agent that achieves a bactericidal concentrations in both the serum and operating site. Use an AMP agent that has little unfavourable side effects. The newer agents should be considered as a therapeutics for Postoperative Infections. The therapeutic antimicrobial agents having no cross-resistance to the AMP agents should be used, if Postoperative Infection is suspected or developed. The most commonly used agent for clean operations are cefazolin (CEZ), followed by cefotiam (CTM) and piperacillin (PIPC), in this order. For clean-contaminated operations, the most commonly used agent is CTM, followed by PIPC and CEZ.
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A questionnaire survey on the theory of Postoperative Infection prophylaxis in gynecology
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases, 2001Co-Authors: Nagao Shinagawa, Shigetomi Iwai, Takashi Yokoyama, Hiromitsu Takeyama, Keiji Mashita, Masayoshi Noguchi, Teruhiko Tamaya, Jinsuke Yasuda, Michiteru FujiiAbstract:A questionnaire survey on the theory of Postoperative Infection prophylaxis was conducted to obtain the consensus on perioperative antimicrobial use among gynecologists in Japan in the period from April to July 2000. Fifty-six of the 83 gynecologists replied, and the following consensus was obtained. An antimicrobial prophylaxis (AMP) agent should be chosen based on their efficacy against the pathogens expected to be contaminants, such as Staphylococcus spp., Escherichia coli and Bacteroides fragilis group. Use an AMP agent that archives a bactericidal concentrations in both the serum and operating site. Use an AMP agent that has little unfavourable side effects. The newer agents should be considered as a therapeutics for Postoperative Infections. The therapeutic antimicrobial agents having no cross-resistance to the AMP agents should be used, if Postoperative Infection is suspected or developed. The most commonly used agent for clean operations are cefazolin (CEZ), followed by cefotiam (CTM) and cefmetazole (CMZ). The most commonly used agent for clean-contaminated operations where low grade level of bacterial invasion expected is CTM, followed by CEZ and CMZ, where as operations where mild grade level of bacterial invasion expected is flomxef (FMOX), followed by CTM and other cephalosporins.
Metin Demircin - One of the best experts on this subject based on the ideXlab platform.
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perioperative hyperglycemia is a strong correlate of Postoperative Infection in type ii diabetic patients after coronary artery bypass grafting
Endocrine Journal, 2002Co-Authors: Murat Guvener, Ilhan Pasaoglu, Metin DemircinAbstract:This study was planned to assess the relationship of perioperative glycemic control to the subsequent risk of infectious complications and to compare early clinical outcomes of coronary artery bypass surgery in diabetics with nondiabetics in a single center. A total of 1090 adults who underwent coronary artery surgery in a five year period were included in a retrospective cohort study based on available chart review. Of 1090 patients, 400 had type II diabetes mellitus. Intraoperative and Postoperative blood glucose levels in diabetic group were manipulated by means of a continuous insulin infusion. Data of pre- and Postoperative blood glucose levels were evaluated with respect to Postoperative Infection risk for diabetics. Risks of early mortality, cerebrovascular accident, and Postoperative Infection in diabetic patients were compared with the nondiabetic group. High preoperative mean glucose levels were the main risk factor for the development of Postoperative Infection (p = 0.012 and p = 0.028 for the mean glucose levels 1 and 2 days before operation, respectively). For diabetic group, of 400 patients 20 (5%) were diagnosed to have Postoperative Infection (superficial sternal wound in 3 (0.75%), donor site Infection in 4 (1%), mediastinitis in 5 (1.25%), urinary tract Infection in 6 (1.5%), and lung Infection in 2 (0.5%) patients). The diabetic group had significantly higher prevalence of mediastinitis, donor site Infection, urinary tract Infection and total Infection (p values were 0.048, 0.013, 0.009, and 0.044, respectively). Early mortality was higher among diabetics than in nondiabetics (1.73% vs 3%, p = 0.048) but the risk of cerebrovascular accident in diabetics was not greater than in nondiabetics in early period. In patients with diabetes who undergo coronary artery bypass surgery, preoperative hyperglycemia is an independent predictor of short-term infectious complications and total length of stay in hospital.
Taiji Tsukamoto - One of the best experts on this subject based on the ideXlab platform.
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significance of anaerobic bacteria in Postoperative Infection after radical cystectomy and urinary diversion or reconstruction
Journal of Infection and Chemotherapy, 2013Co-Authors: Yoshiki Hiyama, Satoshi Takahashi, Teruhisa Uehara, Jiro Hashimoto, Yuichiro Kurimura, Toshiaki Tanaka, Naoya Masumori, Taiji TsukamotoAbstract:Radical cystectomy followed by urinary diversion or reconstruction (RC) is a standard treatment for patients with muscle-invasive bladder cancer. In these operations, a high frequency of complications, especially Postoperative Infection, has been reported. However, there have only been a few studies about Postoperative anaerobic bacterial Infection. To clarify the significance and role of anaerobic bacteria in Postoperative Infection, we retrospectively analyzed cases in which Postoperative Infection by these organisms developed. A total of 126 patients who underwent RC from 2006 to 2010 were included in this study. Various types of Postoperative Infection occurred in 66 patients. Anaerobic bacterial Infections were detected with cultures for urine and blood in one case, for blood in two cases, and for surgical wound pus in four. The frequency of Postoperative anaerobic bacterial Infection in RC was less than that of colon surgery. However, this study revealed the possible development of a nonnegligible number of Postoperative anaerobic bacterial Infections. Therefore, we should consider anaerobic bacteria as possible pathogens in Postoperative Infection after RC.
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A questionnaire survey on the theory of Postoperative Infection prophylaxis in urology
The Japanese journal of antibiotics, 2002Co-Authors: Nagao Shinagawa, Taiji Tsukamoto, Shigetomi Iwai, Tetsuro Matsumoto, Sadao Kamidono, Soichi Arakawa, Takashi Yokoyama, Yutaro Hayashi, Hiromi Kumon, Hiromitsu TakeyamaAbstract:A questionnaire survey on the theory of Postoperative Infection prophylaxis was conducted to obtain the consensus on perioperative antimicrobial use among urologists in Japan in the period from April to July 2000. Sixty-three of the 87 urologists replied, and the following consensus was obtained. An antimicrobial prophylaxis (AMP) agent should be chosen based on their efficacy against the pathogens expected to be contaminants, such as Escherichia coli, Staphylococcus spp., Klebsiella pneumoniae and Bacteroides fragilis group. Use an AMP agent that achieves a bactericidal concentrations in both the serum and operating site. Use an AMP agent that has little unfavourable side effects. The newer agents should be considered as a therapeutics for Postoperative Infections. The therapeutic antimicrobial agents having no cross-resistance to the AMP agents should be used, if Postoperative Infection is suspected or developed. The most commonly used agent for clean operations are cefazolin (CEZ), followed by cefotiam (CTM) and piperacillin (PIPC), in this order. For clean-contaminated operations, the most commonly used agent is CTM, followed by PIPC and CEZ.
Murat Guvener - One of the best experts on this subject based on the ideXlab platform.
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perioperative hyperglycemia is a strong correlate of Postoperative Infection in type ii diabetic patients after coronary artery bypass grafting
Endocrine Journal, 2002Co-Authors: Murat Guvener, Ilhan Pasaoglu, Metin DemircinAbstract:This study was planned to assess the relationship of perioperative glycemic control to the subsequent risk of infectious complications and to compare early clinical outcomes of coronary artery bypass surgery in diabetics with nondiabetics in a single center. A total of 1090 adults who underwent coronary artery surgery in a five year period were included in a retrospective cohort study based on available chart review. Of 1090 patients, 400 had type II diabetes mellitus. Intraoperative and Postoperative blood glucose levels in diabetic group were manipulated by means of a continuous insulin infusion. Data of pre- and Postoperative blood glucose levels were evaluated with respect to Postoperative Infection risk for diabetics. Risks of early mortality, cerebrovascular accident, and Postoperative Infection in diabetic patients were compared with the nondiabetic group. High preoperative mean glucose levels were the main risk factor for the development of Postoperative Infection (p = 0.012 and p = 0.028 for the mean glucose levels 1 and 2 days before operation, respectively). For diabetic group, of 400 patients 20 (5%) were diagnosed to have Postoperative Infection (superficial sternal wound in 3 (0.75%), donor site Infection in 4 (1%), mediastinitis in 5 (1.25%), urinary tract Infection in 6 (1.5%), and lung Infection in 2 (0.5%) patients). The diabetic group had significantly higher prevalence of mediastinitis, donor site Infection, urinary tract Infection and total Infection (p values were 0.048, 0.013, 0.009, and 0.044, respectively). Early mortality was higher among diabetics than in nondiabetics (1.73% vs 3%, p = 0.048) but the risk of cerebrovascular accident in diabetics was not greater than in nondiabetics in early period. In patients with diabetes who undergo coronary artery bypass surgery, preoperative hyperglycemia is an independent predictor of short-term infectious complications and total length of stay in hospital.
W Nussbaumer - One of the best experts on this subject based on the ideXlab platform.
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risk for Postoperative Infection after transfusion of white blood cell filtered allogeneic or autologous blood components in orthopedic patients undergoing primary arthroplasty
Transfusion, 2005Co-Authors: Petra Innerhofer, Anton Klingler, Christian Klimmer, Dietmar Fries, W NussbaumerAbstract:BACKGROUND: This study was designed to obtain data on the incidence of Postoperative Infection in patients undergoing elective orthopedic surgery and receiving white blood cell (WBC)-filtered blood components prepared according to current standards. STUDY DESIGN AND METHODS: A total of 308 consecutive orthopedic patients who opted for preoperative autologous blood donation (PAD) for primary unilateral hip and knee replacement surgery were enrolled in a prospective observational study of the incidence of Postoperative Infection. Patients with contraindications for PAD or with any infectious disease were not included in the study. To identify probably confounding factors, differences between patient groups were analyzed first. Identified factors, which differed between groups, and variables describing blood supply were further tested in uni- and multivariate logistic regression analysis for their independent influence on development of Postoperative Infection. Infection rates were compared on the basis of actual transfusion groups. RESULTS: Of the 308 study patients, 101 were not transfused, 85 received their PAD, 100 received allogeneic WBC-filtered red blood cells (RBCs), and 22 were given autologous RBCs and additionally allogeneic WBC-filtered RBCs. Overall the Infection rate was 6.82 percent (21/308). Infection rates varied significantly between transfusion groups (no transfusion, 6.9%; autologous RBCs, 1.2%; allogeneic WBC-filtered RBCs, 12.0%; both transfusion types, 4.6%; p = 0.03). Allogeneic recipients showed significantly more Infections compared to autologous recipients (p = 0.0053). Multivariate regression analysis confirmed transfusion of allogeneic WBC-filtered RBCs as an independent variable predicting Postoperative Infection (odds ratio, 23.65; confidence interval, 1.3-422.1; p = 0.01). CONCLUSION: Differences in Postoperative Infection rates between allogeneic and autologous recipients are still observable, although universal WBC filtration has been introduced into clinical practice.
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transfusion of buffy coat depleted blood components and risk of Postoperative Infection in orthopedic patients
Transfusion, 1999Co-Authors: Petra Innerhofer, C Walleczek, G Luz, P Hobischhagen, A Benzer, B Stockl, G Hessenberger, W Nussbaumer, W SchobersbergerAbstract:BACKGROUND: Allogeneic blood transfusions have been reported to increase susceptibility to Postoperative Infection, but the findings were inconclusive. This study was designed to investigate the effect of buffy coat-depleted allogeneic and autologous transfusion on Postoperative Infection in patients undergoing orthopedic surgery. STUDY DESIGN AND METHODS: Patients (n = 385) undergoing elective orthopedic surgery (primary and revision joint replacement, spinal, or pelvic surgery) were included in a prospective observational study of the incidence of Postoperative Infection between April and December 1996. Infection rates in patients who received allogeneic buffy coat-depleted blood transfusions were compared with those in patients who received no transfusion or only autologous (buffy coat-depleted) blood. RESULTS: Patients without exposure to allogeneic blood (no blood or only autologous blood) had an Infection rate of 3.9 percent, as compared to a rate of 12.2 percent for those with exposure to allogeneic blood (allogeneic blood, autologous plus allogeneic blood) (odds ratio 3.442; 95% CI, 1.349-10.40; p = 0.006). Of the 385 study patients, 309 underwent primary hip or knee replacement surgery. In this homogeneous subgroup, the Postoperative Infection rate was 4.6 percent after no transfusion or autologous transfusion and 11.9 percent after allogeneic transfusion (odds ratio 2.827; 95% CI 1.059-8.799; p = 0.036). Multivariate regression analysis confirmed buffy coat-depleted allogeneic blood transfusion as an independent variable associated with high risk for Postoperative Infection. CONCLUSION: Buffy coat-depleted allogeneic blood transfusion increases the incidence of Postoperative Infection in patients undergoing uncontaminated orthopedic surgery.