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Role of topical antibiotic prophylaxis in prevention of bacterial translocation into upper trachea in nasally intubated patients undergoing tonsillectomies.
MedLine Citation:
PMID:  23246422     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION: The human oropharynx and nasopharynx are home of different bacteria and fungi. The initial sterile endotracheal tube (ETT) transfers mechanically the bacteria from the nasopharynx and oropharynx to the sterile tracheobronchial tree. We investigated the efficacy of Neomycin-Bacitracin combination spray in the prevention of this bacterial translocation through its application over and inside the lumen of the endotracheal tubes preoperatively. PATIENTS AND METHODS: Ninety patients aged (from 8 to 15 years) with ASA I and II were randomly assigned into 2 groups (45 patients for each): Group I; patients with naso-tracheal intubation which sprayed by placebo spray (Lidocaine) and group II; with naso-tracheal intubation that sprayed with antibiotic spray (combined Neomycin sulphate and Bacitracin) on the outside wall of the tube and inside its lumen. At the end of surgery and immediately after extubation, swabs were taken from the upper trachea using cotton tipped swab for bacterial growth. Inflammatory biomarkers were assessed preoperatively and postoperatively to detect any laboratory differences between both groups. RESULTS: In the control group, all patients had heavy bacterial contamination and they were at either level 3 or 4 colony forming units. Thirty-two patients (71%) were at level 3 while 13 patients (29%) were at level 4. In the study group, there were 28 (62.2%) patients showed no bacterial growth, 15 (33.3%) patients were level 1, and 2 patients (4.4%) at level 2 colony forming units. There were no clinical differences between the 2 groups. Also, there was no significant difference between the 2 groups regarding to their postoperative body temperature although the inflammatory biomarkers were significantly higher in the control group. CONCLUSION: Bacterial translocation by endotracheal intubation to the tracheobronchial tree could be prevented by local antibiotic spray application to outer and inner walls of the endotracheal tubes.
Authors:
Mohamed Abu Samra; Hanaa El Bendary; Salwa M S Hayes; Mona B Elhadidy
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-13
Journal Detail:
Title:  International journal of pediatric otorhinolaryngology     Volume:  -     ISSN:  1872-8464     ISO Abbreviation:  Int. J. Pediatr. Otorhinolaryngol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003603     Medline TA:  Int J Pediatr Otorhinolaryngol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Mansoura University Hospital, Egypt. Electronic address: mabusamra69@yahoo.com.
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