Document Detail


Preoperative cell-mediated immunity and duration of antibiotic prophylaxis in relation to postopertive infectious complications. A controlled trial in biliary, gastroduodenal and colorectal surgery.
MedLine Citation:
PMID:  2678858     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In a prospective controlled trial, 750 patients undergoing elective biliary, gastric or colorectal surgery were randomized to receive short-term or long-term antibiotic prophylaxis--cefotaxime for biliary or gastric, and gentamicin/metronidazole for colorectal operations. In all patients, delayed cutaneous hypersensitivity was preoperatively assessed by simultaneous application of seven standardized recall antigens. Positive reaction was defined as mean diameter greater than or equal to 2 mm, anergy as no positive reaction to any antigen, and a 'score' as the sum (in mm) of all the mean diameters of positive reactions. There was no significant difference in septic complication or mortality rates following short-term vs. long-term prophylaxis. Anergy was found in 21 patients (2.8%), while 63 (8.4%) scored 2-4 and 666 (88.8%) greater than or equal to 5. The incidence of postoperative infectious complications was 25% in the patients with score less than 5 and 10% in those scoring greater than or equal to 5, and the corresponding mortality was 14.3 and 2.1% (both p less than 0.001). In the group with preoperative scores less than 5, the duration of antibiotic prophylaxis influenced neither postopertive infectious complications nor mortality.
Authors:
F Moesgaard; M Lykkegaard-Nielsen
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Acta chirurgica Scandinavica     Volume:  155     ISSN:  0001-5482     ISO Abbreviation:  Acta Chir Scand     Publication Date:    1989 Apr-May
Date Detail:
Created Date:  1989-11-01     Completed Date:  1989-11-01     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7906530     Medline TA:  Acta Chir Scand     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  281-6     Citation Subset:  IM    
Affiliation:
Department of Surgical Gastroenterology C, Rigshospitalet, University of Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Anti-Bacterial Agents / administration & dosage*
Biliary Tract Surgical Procedures / adverse effects*
Cefotaxime / administration & dosage
Clinical Trials as Topic
Duodenum / surgery*
Female
Gentamicins / administration & dosage
Humans
Immunity, Cellular / drug effects*
Male
Metronidazole / administration & dosage
Middle Aged
Prospective Studies
Random Allocation
Stomach / surgery*
Surgical Wound Infection / prevention & control*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins; 443-48-1/Metronidazole; 63527-52-6/Cefotaxime

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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