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Group B Streptococcus
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Patients who are GBS positive are treated with penicillin in labor. Ampicillin is a reasonable alternative. If the patient is penicillin-allergic but not at high risk for anaphylaxis, cefazolin is the agent of choice. For the patient at high risk for anaphylaxis to penicillin and with a cultured isolate sensitive to both clindamycin and erythromycin, treatment with clindamycin is indicated. If the culture is resistant to either clindamycin or erythromycin, or if sensitivities are unknown, then treatment with vancomycin is recommended.
Cesarean Delivery
Published in Vincenzo Berghella, Obstetric Evidence Based Guidelines, 2022
A. Dhanya Mackeen, Meike Schuster
Compared with after cord clamp, administration of antibiotics within 1 hour (optimally about 30 minutes) before skin incision is associated with a lower incidence of endometritis (by 46%) and wound infection (by 41%) [31, 54–62]. Pharmacokinetic studies demonstrate that adequate cefazolin tissue concentration is attained 30 minutes after administration [31, 63, 64]. Systemic administration after cord clamping versus lavage routes of antibiotic administration seem to have similar efficacy to each other [32, 41, 65], but are inferior to administration prior to skin incision.
Group B streptococcus infection
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Although controversy exists regarding screening and treatments of GBS colonization in pregnant women, there is a consensus that chemoprophylaxis in the intrapartum period dramatically reduces the rate of infection in both the mother and the neonate. At present, the most cost-effective strategy of reducing early-onset GBS infection is universal screening of maternal GBS vaginal–rectal colonization at 35–37 weeks of gestation. Intrapartum GBS chemoprophylaxis should be given to patients without antenatal screening who have one of the following risk factors: preterm delivery, prolonged rupture of membranes (>18 h), intrapartum fever, or prior infant with GBS infection. Penicillin G is the drug of choice for this purpose and ampicillin is the alternative. Cefazolin may be used in patients who are allergic to penicillin or cephalosporin without a high risk for anaphylaxis. Patients who have allergy to penicillin with a high risk of anaphylaxis should receive clindamycin if the bacterium is susceptible to both clindamycin and erythromycin or vancomycin otherwise. Maternal vaccination, being developed, appears to be the most cost-effective measure in preventing early-onset GBS neonatal infection.
Autologous fat grafting as a minimally invasive technique to avoid cochlear implant extrusion
Published in Cochlear Implants International, 2022
Mirko Aldè, Riccardo Francesco Mazzola, Umberto Ambrosetti, Federica Di Berardino, Giovanna Cantarella
The autologous fat transfer technique, performed to increase the volume and thickness of the area overlying the R/S and to promote tissue revascularization, involved three steps: fat harvesting, purification and placement. Fat was harvested from the lower abdomen after infiltration by a 10-cc solution of 2% mepivacaine with 1:200 000 epinephrine. A stab incision was performed at the iliac crest, and harvesting was by liposuction with a 3-mm-diameter blunt-tip cannula connected to a 10-ml Luer-Lok syringe. The plunger of the syringe was gently retracted to maintain a negative pressure. The lipoaspirate was centrifuged at 3000 rpm for 3 minutes to remove aqueous, hematic, oily components and debris. The refined fat (8.5 cc) was injected into the scalp overlying the CI R/S by a 21-gauge cannula, using a 3-ml Luer-Lok syringe for a better control of fat placement, taking care not to damage the CI electrode array. The overall duration of the procedure, performed under local anesthesia, was 20 minutes. Cefazolin 2 grams were administered intravenously during surgery to prevent infection.
Effects of Preoperative Pregabalin On Postoperative Pain Control in Total Knee Arthroplasty Surgery
Published in Journal of Investigative Surgery, 2021
Mutlu Akdoğan, Gülten Ütebey, Halis Atıl Atilla, Alper Öztürk, Mehmet Faruk Çatma
All patients received the same postoperative treatment through a patient-controlled analgesia (PCA) delivery system (Abbott Laboratories, Chicago, IL, USA). PCA allows patients to self-administer additional pain killers in predetermined doses for reducing their pain. Accordingly, the patients received 5 mg/hour intravenous tramadol infusion with a bolus dose of 10 mg and a lockout time of 20 minutes for 48 hours. The frequency of pushing to the button of the PCA system and the total amount of tramadol used via the PCA system were recorded. As an antibiotic prophylaxis, 1 g cefazolin sodium was administered intravenously every 8 hours starting 30 minutes prior to the operation and terminated at the 24th hour. As rescue analgesia, the patients received 50 mg dexketoprofen trometamol intravenously twice daily. For nausea and vomiting, 20 mg metoclopramide was administered intravenously at most three times a day. Side effects of narcotic analgesics were recorded.
Investigation of the effects of cephalosporin antibiotics on glutathione S-transferase activity in different tissues of rats in vivo conditions in order to drug development research
Published in Drug and Chemical Toxicology, 2020
Fikret Türkan, Zübeyir Huyut, Parham Taslimi, Mehmet Tahir Huyut, İlhami Gülçin
Antibiotics have significant role in promoting digestion in animals, prohibiting bacterial infection, and replacing nutrients (Manzetti and Ghisic 2014, Sisecioglu et al.2011). Cephalosporins are in the class of β-lactam antibiotics and are the most common employed antibiotics in medicine (Kummerer 2009, Harris et al.2012). The clinical consumption of cephalosporins is tremendous, because they have strong bactericidal capability and wide antibacterial spectrum. Due to the expanding worldwide market demand, the production output of cephalosporins rises yearly. Cefoperazone that is used in this study, belongs to the third-generation cephalosporin group that works via preventing the biosynthesis of bacterial cell Wall (Pfaller et al.2017). Cefuroxime is a second generation semisynthetic cephalosporin (Pfaller et al.2017). It has impressive role against Gram-positive and Gram-negative bacteria, and is less susceptible to most β-lactamases. Cefazolin is the first generation semisynthetic cephalosporin and it posseses significance for treatment of different infections including, bones, lungs, stomach, skin, etc. Cefazolin posseses a potential role against Gram-negative bacteria (Harris et al.2012).