Monday April 23, 2018

Antibiotics after appendicitis surgery prolong hospital stay

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New York: Antibiotic use following surgery for complicated appendicitis may do more harm than good, suggests new research.

The researchers found that patients who received antibiotics following complicated appendicitis surgery remained in the hospital up to one day longer than similar patients who had not received antibiotics.

“Our study indicates antibiotics may not be necessary following surgery for complicated appendicitis,” said lead researcher Dennis Kim from Los Angeles Biomedical Research Institute in the US.

The researchers studied the outcomes over five years for 410 adults with complicated appendectomies, or those where the appendix was found to be perforated or gangrenous.

Post-operative antibiotics were administered to 274 of those patients, or 66.8 percent.

The study compared patients who received post-operative antibiotics to those who had not received the medications and found no significant difference in wound complications among the two groups.

The 274 patients who received post-operative antibiotics did have slightly longer hospital stays – an average of about one day longer – than the patients who did not receive the medication.

“Antibiotics are not without risks, costs or complications. While further study is needed, surgeons and physicians may wish to re-examine or be more selective in deciding which patients may potentially benefit from post-operative antibiotic therapy for complicated appendicitis,” Kim noted.

The study was published online in the American Journal of Surgery.

(IANS)

 

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Surgical Infections More Common in Low-Income Countries, Study Finds

Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four

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Infections at the site of surgery are the most common complications after operations.
Infections at the site of surgery are the most common complications after operations. Wikimedia Commons
  • Infections at the site of surgery are the most common complications after operations
  • Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four
  • More than 1,500 health care providers took part in the research

Surgeries in low-income countries had higher rates of infections than those in higher-income countries, according to a new study published in The Lancet Infectious Diseases.

The authors said their report provided a starting point for making surgery safer.

Infections at the site of surgery are the most common complications after operations. These infections raise the cost of procedures that are already expensive. And they often make recovery longer and more painful.

Also Read: Tips That Will Help In Recovery From Surgery

The study looked at more than 12,000 gastrointestinal surgeries at 343 hospitals in 66 countries.

Marked difference

Overall, about one in 10 patients developed a surgical site infection. But in low-income countries, that rate rose to nearly one in four.

The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery. Wikimedia Commons
The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery. Wikimedia Commons

That’s after taking into account factors such as the patient’s health, the type of surgery and the condition being treated.

Other elements that could have been behind the difference included the kinds of facilities available in low-income countries, or how long it took to get patients to a hospital, said study co-author Ewen Harrison at the University of Edinburgh.

“If you’re in rural sub-Saharan Africa and you’re run over by a car, it may be a number of days before you can get to a hospital,” he said. “During that time, the infection can get into wounds.”

Drug resistance

Another component could have been the availability of effective antibiotics, Harrison said.

Antibiotics were nearly always given before surgery to prevent infection. But overall, about one in five surgical site infections were resistant to these antibiotics. The rate was higher in low-income countries — one in three — but the authors cautioned that they did not have enough data to draw firm conclusions.

Also Read: Study: Partial Dose of Yellow Fever Vaccine Provides Protection

Resistance generally develops faster the more antibiotics are used. The study noted that hospitals in low-income countries gave patients more antibiotics than elsewhere, both before and after surgery.

“That may be completely appropriate if the patients are needing the antibiotics,” Harrison said. “But that may also be an area where the unnecessary use of antibiotics could be reduced in order to reduce drug resistance.”

Antibiotics were nearly always given before surgery to prevent infection. Wikimedia Commons
Antibiotics were nearly always given before surgery to prevent infection. Wikimedia Commons

The authors’ next plan is to test different skin-cleaning techniques, antibiotic-impregnated stitches, and other simple, low-cost methods to reduce surgical site infections in low-income countries.

More than 1,500 health care providers took part in the research. Harrison said the study organizers “crowdsourced” their participants, using social media to recruit young surgeons-in-training around the world.

“They are really the driving force behind the change that we hope to happen,” he said.

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