Disparities in the regional, hospital and individual levels of antibiotic use in gallstone surgery in Sweden

Jaafar, Gona; Darkahi, Bahman; Lindhagen, Lars; Persson, Gunnar; Sandblom, Gabriel

doi:10.1186/s12893-017-0312-0

Cited by 4 publications

(5 citation statements)

References 25 publications

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“…This study was conducted to assess differences in gallstone surgery regarding antibiotic use in Sweden. Significant disparities were found only between hospitals and surgeons [20]. Health service utilization is influenced not only because of the distribution of health service facilities in the region but also influenced by human distribution and supporting environment, which influence decision-making and behavior in relation to service utilization [21].…”

Section: Discussionmentioning

confidence: 99%

Disparity in the Hospitals Utilization among Regions in Indonesia

Mahmudiono

Laksono

2021

Open Access Maced J Med Sci

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The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities. Regions with good economic movements tend to have good accessibility to health care facilities. For this reason, reducing disparity to achieve universal health services is the goal of health planners and policy makers. Chi Square test was used to test dichotomy variables and t-tests was performed for analysing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization. The results of this study showed that disparities between regions in Indonesia exist in term of hospital utilization. The disparities in hospital utilization among regions in Indonesia were associated with: marital status, socioeconomic status, education level, occupation and insurance ownership. However, the difference in odds ratio for mortality between regions decreased compared to the previous period. Conclusion. Disparities in the hospital utilization among region in Indonesia was associated with complex factors from individual characteristics through geographic barriers.

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Section: Discussionmentioning

confidence: 99%

Disparity in the Hospitals Utilization among Regions in Indonesia

Mahmudiono

Laksono

2021

Open Access Maced J Med Sci

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“…This study was conducted to assess differences in gallstone surgery regarding antibiotic use in Sweden. Signi cant disparities were found only between hospitals and surgeons (17). Health service utilization is in uenced not only because of the distribution of health service facilities in the region, but also in uenced by human distribution and supporting environment, which in uence decision making and behavior in relation to service utilization (18).…”

Section: Discussionmentioning

confidence: 99%

Disparity in the Hospitals Utilization among Regions in Indonesia

Laksono¹,

Benyamin²,

Mahmudiono³

2020

Preprint

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Background. The utilization of hospital services is a benchmark for the success of a health care referral system. Indonesia as the largest archipelago in the world encounters challenging conditions along with lack of infrastructure posed economic and health disparity among its regions. Disparities as a result of this development also have an impact on the accessibility of health care facilities.Methods. Chi Square test was used to test dichotomy variables and t-tests were performed for analyzing the difference among continuous variables. These tests were employed to assess the hypothesis that there was significant regional difference in the access of health care in Indonesia. Estimation using multinomial logistic regression test was used to study the disparity between regions in hospital utilization.Results. The results of this study indicate that there were disparities between regions in Indonesia. In the inpatient category all regions have better utilization than the Papua region, except the Sumatra region. The highest disparity occurs between the Nusa Tenggara region and the Papua region. Possibility of utilizing hospital vs. inpatient facilities not using the hospital 1,439 times in adults in the Nusa Tenggara region compared to the Papua region (OR = 1,439; 95% CI = 1,271 - 1,629). In the category of outpatient utilization as well as hospitalization in hospitals, the Papua region has better hospital utilization compared to other regions. The greatest disparity with the Sumatra region (OR = 0.484; 95% CI = 0.392 - 0.597).Conclusion. In conclusion, there were disparities between regions in Indonesia even though the odds ratio for mortality between regions decreased compared to the previous period.Ethical Clearance. The 2013 RISKESDAS survey had ethical clearance that was approved by the national ethical committee in the NIHRD (ethic number: 01.1206.207). Informed consent was used during data collection, which considered aspects of data collection procedure, voluntary, and confidentiality.

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“…Prophylaxis with antibiotics can reduce the risk of bacterial dissemination and, consequently, of post-surgical infections. In similar studies, it was suggested that the use of prophylactic antibiotics in elderly people with comorbidities would be indicated to reduce the risk of infection [32,33].…”

Section: Discussionmentioning

confidence: 99%

Incidence of Bacteriobilia and the Correlation with Antibioticoprophylaxis in Low-Risk Patients Submitted to Elective Videolaparoscopic Cholecystectomy: A Randomized Clinical Trial

Pagani,

Dolfini,

Trazzi

et al. 2023

Antibiotics

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Cholelithiasis has a major impact on global health and affects an average of 20% of the Western population. The main risk factors are females, age over 40 years, obesity and pregnancy. Most of the time it is asymptomatic, but when there are symptoms, they are generally nonspecific. Bile was considered sterile, but today it is known that it contains a complex bacterial flora, which causes biofilm in the gallbladder and gallstones. Among the main bacteria associated with cholelithiasis are Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, species of Enterococcus spp. and Acinetobacter spp. Antibiotic prophylaxis is used in an attempt to reduce postoperative infections, especially at the surgical site. However, some authors found no relationship between the use of antibiotic prophylaxis and a lower risk of surgical site infection. Thus, the aim of this double-blind randomized clinical trial was to compare the existence or not of bacteriobilia in patients at low anesthetic risk who underwent videolaparoscopic cholecystectomy, and its correlation with the use of prophylactic antibiotics. This study included 40 patients between 18 and 65 years old, diagnosed with cholelithiasis, symptomatic or not, with low anesthetic risk classified by the American Society of Anesthesiology in ASA I or ASA II, without complications or previous manipulation of the bile duct, who underwent elective video cholecystectomy, divided into two groups: Experimental Group A (n = 20), which received 2 g of Cephalotin (first-generation Cephalosporin, Keflin®, ABL antibiotics, Cosmópolis, Brazil) during anesthetic induction, and Control Group B (n = 20), where no antibiotics were administered until bile collection. After the procedure, a bile sample was collected and culture and antibiogram were performed. In the sample, 22 (55%) were classified as ASA I and 18 (45%) as ASA II. It was observed that 81.8% of the patients who had a positive culture did not use antibiotics, against 18.2% of those who used prophylaxis. When comparing patients regarding anesthetic risk, ASA I patients had a positive culture in 9.1% of cases, against 90.9% in patients classified as ASA II. It was concluded that patients with higher anesthetic risk (ASA II) have a higher chance of bacteriobilia and benefit from antibiotic prophylaxis when compared to patients with lower anesthetic risk (ASA I).

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Disparities in the regional, hospital and individual levels of antibiotic use in gallstone surgery in Sweden

Cited by 4 publications

References 25 publications

Disparity in the Hospitals Utilization among Regions in Indonesia

Disparity in the Hospitals Utilization among Regions in Indonesia

Disparity in the Hospitals Utilization among Regions in Indonesia

Incidence of Bacteriobilia and the Correlation with Antibioticoprophylaxis in Low-Risk Patients Submitted to Elective Videolaparoscopic Cholecystectomy: A Randomized Clinical Trial

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