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To standardize the use of antibiotics for surgical prophylaxis, ensure patient safety, improve medical quality, and combat bacterial resistance, the editorial committee at Peking Union Medical College Hospital for the management of antibiotics for surgical prophylaxis has formed management practice of perioperative prophylactic use of antibiotics. The management practice, based on the Guideline Principles for the Clinical Application of Antimicrobial Drugs (2015 edition) issued by the National Health Commission of People's Republic of China, also reviews the authoritative literature at home and abroad and combines with our hospital's antimicrobial drugs catalog and characteristics of bacterial resistance, with the hope of promoting the rational use of antibiotics.

To test the effect of prophylactic use of benzhexol in schizophrenia patients after risperidone treatment. Sixty-nine drug naïve schizophrenia patients were recruited. All patients were administered risperidone. Patients in the benzhexol group were given a benzhexol tablet of 2 mg bid daily. The controls received a placebo tablet of 2 mg bid daily. The primary outcome measured using the Extrapyramidal Symptoms Rating Scale (ESRS). The Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) measured secondary outcome. There were significant time and group effects on the ESRS scores of the two groups. The post hoc analysis yielded significant differences at 1, 2, 4, and 8 weeks between the two groups. There was a significant time effect on the PANSS scores of the two groups. No significant group and interaction effects on the PANSS scores of the two groups. There was a significant time effect on the BPRS scores of the two groups. No serious adverse events were found in this study. Prophylactic use of benzhexol reduced extrapyramidal symptom in schizophrenia patients after risperidone treatment and did not affect the antipsychotic action of risperidone.

Febrile neutropenia is a serious chemotherapy-related adverse event that can lead to complications and death and it could be a significant burden on the organization of the health care system. The risk for febrile neutropenia is determined by chemotherapy-induced myelosuppression and the presence of patient-related risk factors. In the literature, various patient-related risk factors are taken into consideration. It was suggested that the patient age is the one of the most important ones. If the estimated risk for the febrile neutropenia is high, prophylactic use of myeloid growth factors (granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor) is recommended. In patients with solid tumors and lymphomas it was shown that the prophylactic use of myeloid growth factors significantly reduces the incidence of febrile neutropenia, early mortality during chemotherapy and infection-induced mortality. In patients who develop febrile neutropenia, there is less evidence for the therapeutic use of myeloid growth factors compared to prophylactic use, although there is a clear benefit in reducing the time to neutrophil count recovery. There is a clear benefit for hospitalized patients, also, in reducing duration of hospitalization. In patients with febrile neutropenia who have not been previously treated with prophylactic myeloid factors, assessment of risk factors for the complications is advised. In patients with high-risk febrile neutropenia therapeutic use of growth should be considered.

What is known and objective: Third‐generation oral cephalosporins, especially cefcapene‐pivoxil (CFPN‐PI), have been used frequently in the Japanese dental field. In December 2014 and April 2016, the newly published clinical guidelines recommended the use of amoxicillin (AMPC). Thus, it is important to evaluate the impact of these guidelines on the prescription profiles of prophylactic antibiotics, clinical outcomes and cost‐effectiveness of antibiotics. Methods: We conducted a retrospective study to analyse an interrupted time series analysis from April 2013 to March 2020 at the Department of Dentistry of Hokkaido University Hospital. A segmented regression model was used to estimate the changes in the incidence of infectious complications following tooth extraction. Prescribed antibiotic data were evaluated via days of therapy (DOT). Antibiotic costs were calculated in terms of the Japanese yen (JPY). Results and Discussion: We identified 17,825 eligible patients. The incidence rates of infectious complications (SSI + dry socket) and SSI after tooth extraction were 3.2% and 2.2%, respectively, during the entire period. The extraction of impacted third molars corresponded to 5.0% and 3.4%, respectively. However, their incidence rates were not significantly different during this period. The use of prophylactic antibiotics and antibiotic cost showed consistent trends following the implementation of guidelines. The mean DOT of CFPN‐PI decreased (ranging from 4893.6 DOTs/1000 patients [March 2013 to November 2014] to 3856.4 DOTs/1000 patients [December 2014 to March 2016]; p < 0.001, and from 3856.4 DOTs/1000 patients [December 2014 to March 2016] to 2293.9 DOTs/1000 patients [April 2016 to March 2020]; p < 0.001). In contrast, the mean DOT of AMPC was found to be increased (ranging from 1379.7 DOTs/1000 patients [March 2013 to November 2014] to 3236.3 DOTs/1000 patients [December 2014 to March 2016]; p < 0.001, and from 3236.3 DOTs/1000 patients [December 2014 to March 2016] to 4597.8 DOTs/1000 patients [April 2016 to March 2020]; p < 0.001). The mean monthly cost was decreased (ranging from 905.3 JPY [March 2013 to November 2014] to 788.7 JPY [December 2014 to March 2016]; p = 0.003, and from 788.7 JPY [December 2014 to March 2016] to 614.0 JPY [April 2016 to March 2020]; p < 0.001). What is new and conclusion: After December 2014, prophylactic antibiotics were switched from CFPN‐PI to AMPC, and the incidence rate of infectious complications was not significantly different over time. However, changing antibiotics is useful from a cost‐effectiveness perspective. [ABSTRACT FROM AUTHOR]

Background: Prophylactic granulocyte-colony stimulating factor (G-CSF) has been shown to effectively prevent febrile neutropenia (FN) and grade 3/4 neutropenia during myelosuppressive treatment. The present study reports the clinical efficacy and safety of the prophylactic use of G-CSF with a half dose for cancer patients with an intermediate risk of FN combined with ≥1 patient-specific risk during multiple chemotherapy. Methods: This multicenter, one-arm, and open-label clinical study involved 151 patients [median age, 54 years old (range, 46.0–62.5); 38.4% female] with malignant tumors, including >20 different cancers. These patients underwent a total of 604 cycles of chemotherapy and received a half dose of PEG-rhG-CSF administration prior to each cycle. Results: The incidence rate of FN was 3.3% for this cohort during chemotherapy. Chemotherapy delay occurred in 6 (4.0%) patients for 12 (2.0%) cycles. Early termination of cancer treatment occurred in 14 (9.3%) patients. In this cohort, 23 (15.2%) patients required antibiotic use during courses of chemotherapy. A total of 28 (18.5%) patients experienced clear adverse effects during cancer treatment. Conclusion: The prophylactic PEG-rhG-CSF with a half dose can both efficaciously and safely prevent neutropenia for patients of diverse cancers with an intermediate risk of FN combined with ≥1 patient-specific risk during chemotherapy. [ABSTRACT FROM AUTHOR]

The aim of this work was to estimate the efficacy and safety of single intramuscular introduction of specific heterologous immunoglobulin as prophylactic drug against Ebola hemorrhagic fever. Materials and methods. The specific heterologous immunoglobulin was introduced as a special prophylactic drug to 28 patients in epidemic situations, after skin hurt with infectious materials or contact with infectious blood. Clinico-laboratory observation was performed in 24 subjects after single intramuscular introduction of heterologous immunoglobulin Ebola. The samples of blood serum were investigated for immunoglobulin Ebola and antibodies to horse gamma-globulin on the 30th and 60th days after prophylaxis. Results. None of the subjects of the study contracted Ebola fever. There were no anaphylactic reactions after special prophylaxis with specific heterologous immunoglobulin. Among the subjects with normal allergic state 31% responded with local reactions; 13%, with a general reaction (mild case of the serum disease). Almost no reaction was observed in patients with unfavorable allergic state subjected to desensitizing therapy; in the absence of desensitizing therapy, 50% of patients with unfavorable allergic state exhibited local reactions; 17%, mild cases of the serum disease; 33%, moderate cases of the serum disease. In summary, if the tactics of immunoglobulin application was right, the quantity of local allergic reactions was 28%; of wide spread reactions, 6%. Weak serum disease was observed in 11% of the subjects. The prognostic period of resistance to Ebola fever was less than 30 days. Conclusion. The prophylactic use of specific immunoglobulin from horse blood serum against hemorrhagic Ebola fever is effective and relatively safe in patients subjected to desensitizing therapy.

Background: Peptic ulcer is a disease affecting a large number of people, caused due to various reasons including infection with H pylori, consumption of alcohol, NSAIDs and stress. Although not a life-threatening disease, it causes undue distress and discomfort and accounts for increased time off from work thereby leading to manpower and economic losses. In this condition, histamine receptor blockers provide relief. Objectives: Natural remedies for peptic ulcer have not been effectively utilized in clinical set up. In the present study, we evaluated the effect of water extract of Glycyrrhiza Glabra L, commonly known as Liquorice on stressinduced gastric inflammation. Materials & Methods: Liquorice extract was prepared. Male Wistar rats (n=5 in each group) were procured from the central animal house and divided into four groups namely Group 1(control); Group 2 (low dose treatment); Group 3 (high dose treatment) and group 4 (prophylactic). They were housed individually and subjected to restraint stress in PVC pipes for 2 hours daily and their stomach was examined for ulcer in Licorice (oral) fed groups and control. Results: Control group showed the inflammatory changes, ulcer index showed a significant lesion, whereas the animals treated with low dose and high dose showed proportionate decrease in the severity of inflammation as evidenced by the histological features. Fourth group of rats which was treated prophylactically before they were subjected to stress, showed no sign of stress-induced inflammatory changes in the gastric mucosa. Conclusion: The results of this study strongly suggested that the G Glabra extract reduces the inflammation and relieves the ulcers and also it can be used as a prophylactic agent to prevent the peptic ulcer in vulnerable subjects. [ABSTRACT FROM AUTHOR]

A mouse model of spontaneous latent tuberculosis infection (LTBI)that mimics latent tuberculosis infection in humans is valuable for drug/vaccine development and the study of tuberculosis. However, most LTBI mouse models require interventions, and a spontaneous LTBI mouse model with a low bacterial load is difficult to establish. In this study, mice were IV-inoculated with 100 CFU Mycobacterium tuberculosis H37Rv, and a persistent LTBI was established with low bacterial loads (0.5~1.5log10 CFU in the lung;

To test the effect of prophylactic use of benzhexol in schizophrenia patients after risperidone treatment. Sixty-nine drug naïve schizophrenia patients were recruited. All patients were administered risperidone. Patients in the benzhexol group were given a benzhexol tablet of 2 mg bid daily. The controls received a placebo tablet of 2 mg bid daily. The primary outcome measured using the Extrapyramidal Symptoms Rating Scale (ESRS). The Positive and Negative Syndrome Scale (PANSS) and the Brief Psychiatric Rating Scale (BPRS) measured secondary outcome. There were significant time and group effects on the ESRS scores of the two groups. The post hoc analysis yielded significant differences at 1, 2, 4, and 8 weeks between the two groups. There was a significant time effect on the PANSS scores of the two groups. No significant group and interaction effects on the PANSS scores of the two groups. There was a significant time effect on the BPRS scores of the two groups. No serious adverse events were found in this study. Prophylactic use of benzhexol reduced extrapyramidal symptom in schizophrenia patients after risperidone treatment and did not affect the antipsychotic action of risperidone., Competing Interests: The authors declare no competing interests., (© 2023 Published by Elsevier Ltd.)

Traumatic brain injury (TBI) describes the presence of physical damage to the brain as a consequence of an insult and frequently possesses psychological and neurological symptoms depending on the severity of the injury. The recent increased military presence of US troops in Iraq and Afghanistan has coincided with greater use of improvised exploding devices, resulting in many returning soldiers suffering from some degree of TBI. A biphasic response is observed which is first directly injury-related, and second due to hypoxia, increased oxidative stress, and inflammation. A proportion of the returning soldiers also suffer from post-traumatic stress disorder (PTSD), and in some cases, this may be a consequence of TBI. Effective treatments are still being identified, and a possible therapeutic candidate is hyperbaric oxygen therapy (HBOT). Some clinical trials have been performed which suggest benefits with regard to survival and disease severity of TBI and/or PTSD, while several other studies do not see any improvement compared to a possibly poorly controlled sham. HBOT has been shown to reduce apoptosis, upregulate growth factors, promote antioxidant levels, and inhibit inflammatory cytokines in animal models, and hence, it is likely that HBOT could be advantageous in treating at least the secondary phase of TBI and PTSD. There is some evidence of a putative prophylactic or preconditioning benefit of HBOT exposure in animal models of brain injury, and the optimal time frame for treatment is yet to be determined. HBOT has potential side effects such as acute cerebral toxicity and more reactive oxygen species with long-term use, and therefore, optimizing exposure duration to maximize the reward and decrease the detrimental effects of HBOT is necessary. This review provides a summary of the current understanding of HBOT as well as suggests future directions including prophylactic use and chronic treatment. [ABSTRACT FROM AUTHOR]

A mouse model of spontaneous latent tuberculosis infection (LTBI) that mimics LTBI in humans is valuable for drug/vaccine development and the study of tuberculosis. However, most LTBI mouse models require interventions, and a spontaneous LTBI mouse model with a low bacterial load is difficult to establish. In this study, mice were IV-inoculated with 100 CFU Mycobacterium tuberculosis H37Rv, and a persistent LTBI was established with low bacterial loads (0.5~1.5log10 CFU in the lung; <4log10 CFU in the spleen). Histopathological changes in the lung and spleen were mild during the first 20 weeks post-inoculation. The model was used to demonstrate the comparative effects of prophylactic and therapeutic administration of Ganoderma lucidum extract (spores and spores lipid) in preventing H37Rv replication in both lung and spleen. H37Rv was inhibited with prophylactic use of G. lucidum extract relative to that of the untreated control and therapy groups, and observed in the spleen and lung as early as post-inoculation week 3 and week 5 respectively. H37Rv infection in the therapy group was comparable to that of the untreated control mice. No significant mitigation of pathological changes was observed in either the prophylactic or therapeutic group. Our results suggest that this new LTBI mouse model is an efficient tool of testing anti-tuberculosis drug, the use of G. lucidum extract prior to M. tuberculosis infection may protect the host against bacterial replication to some extent. [ABSTRACT FROM AUTHOR]

Guidelines change every few years regarding the prophylactic use of Bacille Calmette-Guérin (BCG) against non-muscle invasive bladder cancer. We performed a retrospective comparison to clarify the differences in BCG efficacy, based on time period, between Japan and Western countries . Published literature on 18 Japanese and 28 Western patient studies were compared to evaluate differences in BCG efficacy. Additionally, Internet searches were performed to obtain comparative Japanese and Western data. BCG efficacy in Japanese literature tended to show decreasing non-recurrence rates by time period. Non-recurrence rates in Western countries increased each year. This discrepancy may stem from a number of factors, including changes in accepted BCG indications, the introduction of restaging transurethral resection (re-TUR), the concept of BCG maintenance, and the evolution of histopathological diagnostic criteria. [ABSTRACT FROM AUTHOR]

During a 1-year period, intra-aortic balloon pumps (IABPs) were used in open heart surgery on 57 patients. Indications were prophylactic usage for coronary artery bypass grafting (CABG) in 52 patients, prophylactic usage for valve replacement in three patients, and cardiopulmonary bypass (CPB) weaning during valve replacement in two patients. The 52 CABG patients comprised 94.5% of all CABG procedures during the period. Sheathless 8 Fr IABPs were used in all cases. The 57 patients using IABPs were analyzed. The mean duration of IABP use was 41.7 h. Morbidity was not associated with using IABPs. There was one case of balloon rupture. Hemostasis was performed easily after removing IABP catheters by compressing the groin for approximately 15 min. The lowest blood pressure during anastomosis or cardiac arrest was also assessed. The lowest peak pressure was 55.9 ± 17.3 mm Hg for patients with IABP still turned on, and the lowest mean pressure was 34.7 ± 6.5 mm Hg for patients with IABP temporarily turned off. Peak blood pressure after CPB was 73.8 ± 17.8 mm Hg. During open heart surgery under anesthesia with the low blood pressure presented by this series, use of IABPs enabled patients to tolerate the procedure. In conclusion, aggressive use of IABPs is easy, safe, and effective with no related morbidity. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the prophylactic use of antibiotics in type Ⅰ incision during perioperative period in the First Maternal and Child Health Hospital of Huizhou (hereinafter referred to as "our hospital"), and to evaluate the rationality so as to provide basis for the hospital quality control and improve the level of use of antibiotics in our hospital. METHODS: 613 medical records of type Ⅰ incision were extracted from our hospital during Jul. 2014 to Jun. 2015, the use of antibiotics during perioperative period were statistically analyzed. RESULTS: The rate of prophylactic use of antibiotics was 28. 71% (176 /613), the rate of prophylactic use of no indications was 2. 12% (13 /613). Of the 176 cases of patients with prophylactic use of antibiotics, the rational rate of variety selection was 81. 82% (144 /176), the rational rate of delivery time was 88. 07% (155 /176), and the rational rate of treatment course was 86. 36% (152 /176). CONCLUSIONS: The rate of prophylactic use of antibiotics in type Ⅰ incision during perioperative period in our hospital has reached the provisions of the Ministry of Health (< 30%), yet there are still some problems as irrational variety selection, improper delivery time and irrational treatment course; therefore, the level of use of antibiotics still needs to improved. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To investigate the basic situation of prophylactic use of antibiotics in heart permanent pacemaker implantation surgery during perioperation in a heart specialized subject hospital, so as to provide reference for the standardize use of antibiotics and establish effective intervention measures. METHODS: 221 patients with heart permanent pacemaker implantation surgery admitted into Wuhan Asia Heart Hospital (hereinafter referred to as "our hospital") from Jan. to Jun. 2014 were investigated, statistical analysis was conducted on the prophylactic use of antibiotics. RESULTS: Of the 221 cases, there were only 204 cases met the criteria. As for the 204 cases, the prophylactic use rate of antibiotics was 100%; 179 cases (87.75%) were in rational administration time. Duration of prophylactic administration were 175 cases (85.78%). There were 4 kinds of prophylactic use of antibiotics, cephalosporin (182 cases) took the lead of number of cases, followed by β-lactamase inhibitor compound (1 case), fluoroquinolone (1 case) and lincosamide (20 cases). CONCLUSIONS: The prophylactic use of antibiotics in heart permanent pacemaker implantation surgery during perioperation was irrational to some extent, it is necessary to attach more importance by the clinicians. [ABSTRACT FROM AUTHOR]

Abstract: Objective: We sought to evaluate the effects of manual thrombectomy on myocardial reperfusion performed during percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). Background: Complete reperfusion after primary PCI is compromised by the presence of intraluminal thrombus. Thus effective and safe extraction of thrombus in a timely fashion is important for successful reperfusion. Methods: Thirty-two patients (age 51±12 years, males 78%) with STEMI and angiographic evidence of intraluminal thrombus underwent thrombectomy during an 18-month period. Thrombectomy was performed after the presence of thrombus was confirmed angiographically by the operator either before or after primary angioplasty. Thrombectomy was performed using the 6F Export Aspiration Catheter (Medtronic Corporation, Santa Rosa, CA, USA). Myocardial reperfusion using Thrombolysis in Myocardial Infarction (TIMI) flow and myocardial blush grade was assessed by two independent observers. Results: The infarct-related artery was left anterior descending (59%), right coronary artery (19%), saphenous venous graft (19%), or left circumflex artery (3%). The coronary lesion was Type B in 62% and Type C in 37% patients, with an average length of 18.2+4.6 mm and reference vessel diameter of 3.2±0.4 mm. The preprocedural TIMI flow was 0 in 62%, 1 in 12%, 2 in 22%, and 3 in 3% of patients. The postprocedural TIMI flow was 0 in 3%, 1 in 6%, 2 in 25%, and 3 in 56% of patients. The postprocedural myocardial blush grade was 0 in 6%, 1 in 9%, 2 in 35%, and 3 in 48% of patients. The in-hospital mortality was 0 and the 30-day mortality was 3%. Conclusion: Manual thrombectomy using an Export catheter is safe and effective in establishing myocardial reperfusion after STEMI. [Copyright &y& Elsevier]

Abstract: The possibilities and limits of antibiotic cements (ACs) have been assessed by many researchers. ACs are now approved by many drug agencies, including the US Food and Drug Administration (approval in 2003), with widespread use in prophylaxis and curative treatments. Laboratory experiments have achieved satisfactory antibiotic delivery without impairing the mechanical properties of ACs. Implantation in large animals (e.g. sheep) showed an antibiotic concentration in the bone cortex four times the minimal inhibitory concentration (MIC) 6 months after implantation. Human pharmacokinetics during total hip replacement (THR) show antibiotic concentrations 20 times the MIC in drainage fluids. No toxic concentrations have been detected in blood or urine, and no allergies, toxic effects, mechanical failures or selection of resistant microorganisms have been observed. Antibioprophylaxis has been assessed in prospective studies in over 1600 cases. In data from the Scandinavian arthroplasty registers, with an exhaustive follow-up of more than 240000 THRs, infection rate was reduced by ca. 50% (0.9% compared with 1.9%). In prostheses with severe infection, use of AC increases the infection control rate from 86% to 93% when using two-stage prosthetic exchanges. In moderate infection, a similar infection control rate (86%) was achieved either by two-stage exchange without local antibiotic or by one-stage exchange with AC; however, one-stage exchange achieved better functional results at lower cost and with reduced pain and hospital stay. Therefore, AC prophylaxis is widely used in countries with prostheses registers (Northern Europe), and use of ACs as treatment for infected prostheses is often considered as the gold standard in the EU and North America. However, AC is only an adjuvant treatment, and excision of infected and devascularised tissues as well as systemic antibiotic treatment managed by a multidisciplinary team remain the main factors of infection control. [Copyright &y& Elsevier]

Para actualizar la Guía de Buenas Prácticas Médicas sobre el uso de antimicrobianos, en el Servicio de Cirugía General del Hospital Clinicoquirúrgico «Joaquín Albarrán», se analizaron, discutieron y aprobaron de forma colectiva las directrices sobre el uso de antibióticos ante cada proceso morboso, en dicho servicio. Se ofrecen recomendaciones sobre la elección de los fármacos según las disponibilidades de la institución, uso profiláctico, momento de comienzo, vía de administración y duración del tratamiento. El hecho de disminuir o evitar la infección de las heridas quirúrgicas confiere a este tipo de análisis importancia singular en la cirugía moderna, por lo que es imprescindible su actualización sistemática.To update the Good Medical Practices Guide on the use of antimicrobials in the General Surgery Service of the "Joaquín Albarrán" Cliical Surgical Hospital authors analyzed, discussed and approved in a collective way the guidelines in each morbid process in such service offering recommendations on the drugs choice according to the institution availabilities, the prophylactic use, onset time, administration route and treatment length. To decrease or avoid the infection in the surgical wounds give to this type of analysis a peculiar significance in the current surgery, thus, it is necessary its systemic updating.

A mouse model of spontaneous latent tuberculosis infection (LTBI) that mimics LTBI in humans is valuable for drug/vaccine development and the study of tuberculosis. However, most LTBI mouse models require interventions, and a spontaneous LTBI mouse model with a low bacterial load is difficult to establish. In this study, mice were IV-inoculated with 100 CFU Mycobacterium tuberculosis H37Rv, and a persistent LTBI was established with low bacterial loads (0.5~1.5log10 CFU in the lung; < 4log10 CFU in the spleen). Histopathological changes in the lung and spleen were mild during the first 20 weeks post-inoculation. The model was used to demonstrate the comparative effects of prophylactic and therapeutic administration of Ganoderma lucidum extract (spores and spores lipid) in preventing H37Rv replication in both lung and spleen. H37Rv was inhibited with prophylactic use of G. lucidum extract relative to that of the untreated control and therapy groups, and observed in the spleen and lung as early as post-inoculation week 3 and week 5 respectively. H37Rv infection in the therapy group was comparable to that of the untreated control mice. No significant mitigation of pathological changes was observed in either the prophylactic or therapeutic group. Our results suggest that this new LTBI mouse model is an efficient tool of testing anti-tuberculosis drug, the use of G. lucidum extract prior to M. tuberculosis infection may protect the host against bacterial replication to some extent.