Antibiotic therapy, prophylactic

Initiation of prophylactic antibiotics is recommended during acute variceal bleeding this is typically done with an oral fluoroquinolone (e.g., ciprofloxacin 500 mg twice daily x 7 days) or an IV third-generation cephalosporin. Prophylactic antibiotic therapy reduces in-hospital infections and mortality in patients hospitalized for variceal bleeding.44... 

Most bite wounds require antibiotic therapy only when clinical infection is present. However, prophylactic therapy is recommended for wounds at higher risk for infection. These include human bites, deep punctures, bites to the hand, and bites requiring surgical repair.43... 

Patients with noninfected bite injuries should be given prophylactic antibiotic therapy for 3 to 5 days. Amoxicillin-clavulanic acid (500 mg every 8 hours) is commonly recommended. Alternatives for penicillin-allergic patients include fluoroquinolones or trimethoprim-sulfamethoxazole in combination with clindamycin or metronidazole. First-generation cephalosporins, macrolides, clindamycin alone, or aminoglycosides are not recommended, as the sensitivity to E. corrodens is variable. 

This disease was first observed in the mid- to late-1970s when several patients presented with recurrent bacterial infections, primarily of the skin and subcutaneous tissues, middle ear and oropharyngeal mucosa. When examined in vitro, the neutrophils from these patients had defects in chemo-taxis, phagocytosis, particle-stimulated respiratory-burst activity and granulation. Some patients also had a leukocytosis, and many had a delayed umbilical cord separation. Treatment is by prophylactic antibiotic therapy and aggressive antibiotic therapy during infections, but mortality rates are very high. 

One should consider infiuenza- and pneumococcal-vaccination in patients with increased risk for lower RTI including patients with chronic obstructive pulmonary disease like chronic bronchitis or emphysema and cystic fibrosis patients. It should be considered for the elderly population in general. There is no role for prophylactic antibiotic therapy in patients with frequent RTI. Attempts should be made to have those patients that smoke stop doing so. 

Topical antibiotics are typically available as ointments and are excellent for use on open wounds. Coupled with the antibacterial action of the antibiotic ingredient, topical antibiotic ointments provide a safe and effective option in wound healing. In addition, topical antibiotics are effective for the localized treatment of primary and secondary pyodermas with minimal systemic side effects.14 Prophylactic uses include application for traumatic and surgical wounds, burns, intravascular catheters, and eradication of S. aureus nasal carriage.16 42 The advantage of antibiotic therapy in the treatment of eczematous skin will be discussed in the following article considering AD as an example. 

A 70 year old alcoholic male with poor dental hygiene is to have his remaining teeth extracted for subsequent dentures. He has mitral valve stenosis with mild cardiac insufficiency and is being treated with capto-pril, digoxin and furosemide. The dentist decides that his medical history warrants prophylactic antibiotic therapy prior to the procedure and prescribes ... 

Small corneal abrasions typically heal quickly (24 to 36 hours). Topical prophylactic antibiotic therapy protects the disrnpted corneal epithelium from secondary infection as the tissne heals. Broad-spectrum ophthalmic antibiotic drops, snch as 0.3% tobramycin or 0.5% moxi-floxacin, may be instilled four times daily, along with a broad-spectrnm antibiotic ointment such as 0.3% tobramycin or 0.3% ciprofloxacin instilled at bedtime. Prophylactic topical antibiotic therapy can be discontin-ned once the corneal epithelium has healed. 

More severe forms of toxic keratitis may require prophylactic antibiotic therapy to protect the inflamed cornea. The use of topical aminoglycosides should be avoided, however, as they tend to exacerbate the condi-tion.The use of a mild steroid, such as 0.12% prednisolone drops four times a day, aids the resolution of more advanced cases. Any allergic component involving the eyelids or conjunctiva should be treated appropriately. 

Unlike dendritic keratitis, indolent ulcers are typically very difficult to treat. Instillation of a prophylactic antibiotic, such as polymyxin B-bacitracin ointment two to four times a day, and a cycloplegic agent, such as 5% homatropine two to three times a day, is indicated. Therapeutic soft contact lens use with appropriate antibiotic therapy can also be considered as alternatives. These patients must be monitored carefully to ensure that no secondary infection develops. If the ulcer deepens, a new infiltrate forms, or if there is an increase in the anterior chamber reaction while the patient is being treated, cultures should be performed to rule out bacterial or fungal infection. Cyanoacrylate glue, conjunctival flap surgery, or tarsorrhaphy may be required if healing does not occur. 

The authors recommended that bronchoscopy should be performed early after aspiration to extract barium from the bronchial tree, and that prophylactic antibiotic therapy is important to prevent lung infection. 

Absolute neutrophil count <0.500x10 cells L. Antibiotic therapy should be continued until neutrophil recovery has occurred. Follow Infectious Diseases Society of America guidelines (17) for febrile neutropenia if fever develops while the patient is taking prophylactic medication Tf resources are available... 

Uh189] To conduct DUE of prophylactic antibiotic therapy and determine cost savings to hospital OA Pre/post None DCA, number of inappropriate orders Projected annual cost savings 25,000 Input costs not considered... 

An earlier study has Indicated the ability of parenteral prophylactic antibiotic therapy to reduce the Incidence of prosthetic mitral valve failure In dogs associated with valve related Infections. As an alternative to the above approach, we have Investigated the therapeutic efficacy of a system providing for a sustained release of gentamicin, Incorporating the antibiotic In silicone rubber which Is In the sewing rim of a mitral valve prosthesis Implanted In dogs. 

It is essential to ensure that prophylactic immunizations and antibiotics are being given. When infections do occur, appropriate antibiotic therapy should be initiated and the patient should be monitored for laboratory and clinical improvement. The efficacy of hydroxyurea can best be assessed in terms of the decrease in number, severity, and duration of sickle cell pain crises. Fetal hemoglobin concentrations or MCV values may also provide some indication of the patient s response to therapy. When painful crises do occur, the evaluation of the effectiveness of analgesics depends mainly on the subjective assessments made by the patient, family, and health care practitioners. The success of poststroke blood transfusions can be measured by clinical progression or the occurrence of subsequent strokes. 

Patients with noninfected hand bite injuries should be given prophylactic antibiotic therapy. Initial therapy should consist of a penicillinase-resistant penicillin (dicloxacillin 250-500 mg orally four times daily in children, 25-50 mg/kg per day orally divided into four doses) in combination with penicillin VK 250-500 mg orally four times daily (in children, 40,000-90,000 units/kg per day orally divided into four doses). Prophylactic therapy should be given for... 

Prophylactic antibiotic therapy differs from presumptive and therapeutic antibiotic therapy in that the latter two involve treatment regimens for documented or presumed infections, whereas the goal of prophylactic therapy is to prevent infections in high-risk patients or procedures. 

Despite the importance of appropriately timed prophylactic antibiotic therapy, few patients receive antibiotics at the optimal time in relation to surgery. Potential barriers include antibiotics ordered after the patient has arrived in the operating room, delayed antibiotic preparation or delivery, and the use of antibiotics that require long infusion times. One study assessed the timing of prophylactic antibiotics in 100 patients and found that only 26% of patients received an antibiotic dose within 2 hours of the initial surgical incision. ... 

The effect of a biological weapon on a population can be seen in the recent terrorist attack on the east coast of the United States in September 2001. Anthrax spores were delivered through the mail and resulted in 11 cases of inhalational anthrax and 12 cases of the cutaneous form of the disease. Even on this small scale, the effect on the public health system was enormous, and an estimated 32,000 people received prophylactic antibiotic therapy. 

Geschwind JF, Kaushik S, Ramsey DE, Choti MA, Fishman EK, Kobeiter H (2002) Influence of a new prophylactic antibiotic therapy on the incidence of liver abscesses after chemoembolization treatment of liver tumors. J Vase Interv Radiol 13 1163-1166... 

If VUR is demonstrated, the patient is given prophylactic antibiotic therapy and followed up clinically and by imaging for 2 years with the hope that the VUR will resolve spontaneously. During this period of time, renal growth is monitored every 2-3 months using US and renal function every 6 months with isotope studies. The resolution of VUR is verified every year on isotopic or radiological VCU. 

Many series have shown that 2/3 of neonatal VUR (yet, mainly grades I-III) are likely to resolve or at least to improve during an observation period of 2 years. Therefore, once the anomaly is detected the patient is given prophylactic antibiotic therapy and followed clinically and by imaging as described above. In some circumstances another therapeutic approach (surgery or endoscopic injection of collagen) should be proposed in the case of infection despite therapy, if there is failure to thrive, or if... 

Like VUR, UVJ obstruction has shown great potential for spontaneous resolution, probably because of the maturation of the UVJ (Fig. 13.22). Therefore, after completion of the workup a prophylactic antibiotic therapy should be started and the urinary tract monitored by US and eventually isotopes. US may underestimate the dilatation, especially since the renal pelvis may not be dilated. Therefore, before confirming complete resolution, morphological assessment of the urinary tract may be necessary (best by MR urography) (Baskin et al. 1994 Liu et al. 1994 Avni et al. 1992 Avni et al. 2000). 

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