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 in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
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