Antibiotic prophylaxis in biliary surgery

Abstract

Early studies in which a higher incidence of wound infection and septic complications in biliary surgery was found demonstrated the need for antibiotic prophylaxis. In two studies, one retrospective and one prospective, the role of prophylactic antibiotics in biliary surgery was studied in "at risk" and "no risk" groups of patients. Twenty-eight percent of "no risk" patients had a positive bile culture. It was concluded that a single dose of 1 g cefotaxime, administered upon induction of anaesthesia, is a safe and effective prophylactic regimen in biliary surgery.

Amoxicillin/Clavulanic Acid Versus Cefotaxime for Antimicrobial Prophylaxis in Abdominal Surgery: A Randomized Trial

“…The same is true for cefotaxime: the wound infection rate reported in the main studies in which the same single dose was used (2 g) ranges from 0 to 9% versus 0-6.7% in this study [15][16][17][18][19][20] .…”

“…Moreover, the antibiotic levels in tissues during surgery are similar for the two drugs. Both these drugs have the essential characteristics of the antibiotics to be used in the prevention of postoperative abdominal infections [15][16][17][18][19]21,22,24 , including: bactericidal action, broad spectrum of activity, intravenous administration, rapid tissue penetration, serum elimination halflife of at least one hour, and high therapeutic index.…”

“…Recently second and third generation cephalosporins have been the most widely used drugs for antimicrobial prophylaxis in surgery 7,10,13,14 . In particular cefotaxime has been largely used for its broad spectrum of action against the majority of causative pathogens for abdominal infection [15][16][17][18][19][20] . However the extensive use of cephalosporins may exert selective pressure on bacteria and induce bacterial resistance, so that alternative choices of treatment are desirable.…”

The Success of the Link Model Programme in Rural Bangladesh: An Empirical Analysis

“…A number of participatory rural appraisal (PRA) approaches have been introduced in Bangladesh to mitigate the wide administrative gap between the villagers and the local administration, as well as to enable the rural population to gain access to administrative services and information (Ali, 1979; Chambers, 1994; Mascarenhas et al, 1991). ‘ Link Model’, an experimental PRA development programme, has gained particular attention in Bangladesh in the last few decades (Kaida, 2003).…”