Infectious Diseases Literature Summaries
Steinberg, J.P. et al (2009) “Timing of antimicrobial prophylaxis and the risk of surgical site infections” Ann Surg 250:10-16
- aim = to establish the best timing, duration and regimen of surgical antimicrobial prophylaxis for prevention of surgical site infection (SSI)
- prospective, observational study – four groups:
- (1) vancomycin/fluroquinolones given within 60 min or cephalosporins within 30min prior to incision
- (2) vancomycin/fluroquinolones given 61-120 min prior to incision or cephalosporins 31-60 minutes piror to incision
- (3) antibiotics given earlier than above
- (4) post-incisional antibiotics
- n = 4472
- 29 hospitals
- risk of SSI
- (1) 2.1%
- (2) 2.4%
- (3) 2.8%
- (4) 5.3%
- -> give antibiotics between 1 and 30 min prior to incision
- -> redose during long operations
de Jonge, E et al (2003) “Effects of selective decontamination of digestive tract on mortality and acquisition of resistant bacteria in intensive care: a randomised controlled trial” Lancet 362:1011-1016
- RCT
- unblinded, single centre
- n = 934
- PO polymixin E, tobramycin and amphortericin B, + IV cefotaxime VS standard treatment
-> significant reduction in ICU and hospital mortality in SDD group
-> no difference in colonisation with MDR organisms
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at The Alfred ICU, where he is Deputy Director (Education). He is a Clinical Adjunct Associate Professor at Monash University, the Lead for the Clinician Educator Incubator programme, and a CICM First Part Examiner.
He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives. He was one of the founders of the FOAM movement (Free Open-Access Medical education) has been recognised for his contributions to education with awards from ANZICS, ANZAHPE, and ACEM.
His one great achievement is being the father of three amazing children.
On Bluesky, he is @precordialthump.bsky.social and on the site that Elon has screwed up, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC