Management of facial soft-tissue injuries
John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan in Operative Oral and Maxillofacial Surgery, 2017
Facial wounds can be categorized as clean or contaminated. Fresh clean wounds are usually in no need of prophylactic antibiotics. The rate of infection increases and is directly related to the length of time that has elapsed since the initial injury. Skin wounds are usually contaminated with Streptococcus and Staphylococcus. Wounds that involve mucosal lining of the oral cavity are contaminated by oral flora. Through- and-through lacerations between oral cavity and facial/ neck skin are considered contaminated. The number of bacteria present in the wound is more important than the type of bacteria in causing infections. Simple lacerations and abrasions have low bacterial content and very low chance of developing infection. On the other hand, crushing injuries, presence of foreign bodies in the wound, oro-cutaneous communication and animal or human bites lead to increase number of bacteria and much higher rates of infection. Additionally, it is very important to evaluate the immune status of the host and consider the comorbidities as well including poorly controlled diabetes, history of steroid use, malnutrition and so on. In these cases, antibiotic prophylaxis should be considered.
Infectious Disease
John S. Axford, Chris A. O'Callaghan in Medicine for Finals and Beyond, 2023
The introduction of highly active antiretroviral therapy (HAART) has transformed the clinical landscape of HIV care. For patients, this therapy has brought about improvement in the CD4 count and a fall in the HIV viral load. ‘Treatment as prevention’ means that successful suppression of HIV viral load by HAART makes the risk of transmission of HIV from an infected person to their uninfected partner negligible.Some HAART regimens are now available as combined single-tablet, once a day treatment.Anti-HIV drugs are used as post-exposure prophylaxis (PEP), e.g. for a healthcare worker who receives a needlestick injury from someone with known uncontrolled HIV, or after high-risk sexual intercourse (PEPSI).It has recently been established that prescribing antiretrovirals to people at high risk of acquiring HIV through their sexual lifestyle is effective in lowering transmission (pre-exposure prophylaxis, PrEP).
HIV, STIs, Risk Taking and Sexual Health
Jane M. Ussher, Joan C. Chrisler, Janette Perz in Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Recent technological advances mean that there are now a range of biomedical approaches to preventing HIV and STIs (Padian et al., 2011). Where available, vaccination is a highly effective means of reducing STI rates. HPV vaccination programs have led to a significant reduction in HPV in settings where there has been wide-scale roll out of the vaccine (Brotherton et al., 2016). Along with this, widespread testing and treatment programs have the potential to increase early diagnosis of HIV or STIs in order to expedite uptake of treatment and prevent onward infection (Ortayli et al., 2014). Novel approaches to HIV/STI testing, such as home-testing kits and point-of-care testing (which provides results within the clinical session), are creating new opportunities to expand and increase testing (Taylor, Frasure-Williams, Burnett, & Park, 2016; Toskin, Blondeel, Peeling, Deal, & Kiarie, 2017). For HIV, pre-exposure prophylaxis (PrEP) provides the possibility for a significant reduction in new HIV infection rates in coming years (Padian et al., 2011). PrEP is antiretroviral medication taken orally by HIV-negative people to prevent HIV infection. Studies to date show that PrEP is highly effective in reducing HIV transmission among women and men given proper adherence to the treatment regimen (Flash, Dale, & Krakower, 2017).
Colony stimulating factors for prophylaxis of chemotherapy-induced neutropenia in children
Published in Expert Review of Clinical Pharmacology, 2022
Common regimens used for prophylaxis of infection in high-risk patients are antibacterial, antifungal, and antiviral agents, colony stimulating factors, and vaccination [2]. Fluoroquinolones are often the first choice for high-risk patients with expected prolonged and profound neutropenia. Levofloxacin and ciprofloxacin have been evaluated comprehensively. For low-risk patients where anticipated neutropenia is less than 7 days, antibacterial prophylaxis is not usually recommended. Similarly, empirical and/or preemptive antifungal therapy is considered in patients with persistent or recurrent fever after 4 to 7 days of antibiotics and prolonged neutropenia is expected. Antiviral prophylaxis is mostly focused on herpes simplex virus (HSV) and respiratory virus such as influenza. Acyclovir prophylaxis treatment is recommended in HSV-seropositive patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) or leukemia induction therapy [2].
Infections and Colon Surgery: Preliminary Results from a Surveillance Program in an Italian Hospital
Published in Hospital Topics, 2023
Giancarlo Ripabelli, Angelo Salzo, Michela Lucia Sammarco, Giuliana Guerrizio, Giuseppe Cecere, Manuela Tamburro
Antibiotic prophylaxis is useful to prevent antimicrobials overuse, misuse and abuse, as well as helpful to reduce SSIs incidence, and minimize effects on the patient’s bacterial flora and changes to the immune defenses (Murri et al. 2016). Indeed, perioperative prophylaxis must be carried out with the right antibiotic, dose and timing, based on the classification of the intervention, in line with the most recent guidelines for the control of HCAIs, and taking into account the occurrence of bacterial resistance (Crader and Varacallo 2020; Napolitano et al. 2013). Although the causative pathogens of SSIs depend on the type of surgery, Staphylococcus aureus, coagulase-negative staphylococci, Enterococcus spp. and Escherichia coli represent the microorganisms most frequently isolated (Owens and Stoessel 2008; Weigelt et al. 2010; Eisner et al. 2020).
Clinical outcomes for congenital heart disease patients presenting with infective endocarditis
Published in Expert Review of Cardiovascular Therapy, 2020
The new recommendations stipulate that prophylaxis is indicated for any procedure which causes damage to the gingival tissue and the periapical region or which induces perforation of the oral mucosa, i.e., biopsies, sutures, set-up orthodontic rings, dental extractions, but do not include local anesthetic injections, dental X-rays, the placement of removable orthodontic appliances, and the placement or adjustment of dental supports. The new guidelines recommend prophylaxis only for these procedures, restricted to patients belonging to the high-risk group, and insist on the essential point which is a rigorous oral and skin hygiene [53]. The specific point of piercings and tattoos is not addressed in the recommendations, but cases of IE have been reported in the literature [73,74], occurring during these procedures on skin tissue, and Shebani et al [73] recommend in their practice, antibiotic prevention before any gesture of this type although this is not explicitly stipulated in the recommendations.
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