Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a randomized prospective trial of prophylactic antibiotics in at-risk abdominal surgery, one dose of intravenous Augmentin (amoxycillin 250 mg and clavulanic acid 125 mg) on induction has been compared with three 8 hourly doses in 900 patients. Wound infection rates which included minor and delayed infections were very similar in those given one dose: 48/449 (10.7%) compared with those given three doses: 49/451 (10.9%) 95% confidence limits - 4.25% + 3.9%. There were more septic and sepsis-related deaths in those patients given one dose (14 deaths) than in those given three doses (7 deaths) P > 0.1 95% CL - 0.4% + 3.0%. However, there were more very elderly patients in the one dose group: 64% of the deaths were aged over 80 and all but one had an emergency operation. There was no difference in the other outcome measures studied which included non-fatal deep sepsis, length of postoperative hospital stay, duration of postoperative fever or the use of antibiotics for postoperative infection. One dose of a suitable intravenous antibiotic gives prophylaxis against wound infection in at-risk abdominal surgery which is at least as effective as multiple doses. However, there may be a risk of overwhelming systemic sepsis in very elderly patients having emergency surgery.
 ...
PMID:A randomized trial of one versus three doses of Augmentin as wound prophylaxis in at-risk abdominal surgery. 146 53

A small prospective trial was conducted to evaluate the effectiveness and safety of a single antibiotic regimen, Augmentin, compared with a combination regimen of cefuroxime and metronidazole in the treatment of serious post-operative sepsis. Both regimens used were effective against Bacteroides and other anaerobes, with a similar satisfactory cure rate and no serious side effects. Intravenous Augmentin was easy to use and the change to oral therapy was significantly quicker than in the cefuroxime-metronidazole treatment arm. No significant resistance or serious adverse reaction was noted. The majority of patients had more than one site of infection, making selective antibiotic treatment difficult.
 ...
PMID:Effectiveness of two therapeutic antibiotic regimens in the treatment of serious post-operative infections. 269 86

The risk factors for sepsis after vascular surgery were studied in 100 consecutive patients with lower limb arterial ischaemia. Patients were randomised either to a short or long course of antibiotic prophylaxis with amoxycillin/clavulanic acid combination (Augmentin). Pathogenic organisms were isolated from the skin preoperatively in 39 (36%) cases, significantly more frequently in patients with ischaemic rest pain and skin necrosis (66%) than rest pain alone (21%) (P = 0.0004) or claudication/aneurysm (11%) (P = 0.0001). All but three organisms isolated (5%) were sensitive to amoxycillin/clavulanic acid. A wound infection occurred after 21 (19%) reconstructions, significantly more frequently both in patients suffering rest pain with skin necrosis (P = 0.001) and rest pain without skin necrosis (P = 0.04) compared with claudication/aneurysm. Sixteen of the 21 patients with a wound infection had at least one organism isolated from their skin preoperatively (P = 0.0001). Twelve patients (57%) had a similar organism isolated from the skin preoperatively and from the postoperative wound infection. Reducing the course of antibiotic prophylaxis from 5 days to 3 doses did not significantly increase the infection rate. The only other significant risk factor for sepsis was increasing age of the patient. Although prophylaxis is undisputed in patients having synthetic grafts, antibiotics may not be as important in the prevention of wound sepsis as had been thought. The role of antiseptic agents requires further evaluation.
 ...
PMID:Risk factors in vascular surgical sepsis. 340 72

Two hundred and fifty patients were admitted to a prospective randomized trial to compare the efficacy of Augmentin with metronidazole in the prevention of sepsis after appendicectomy. Pre-operatively they received either 500 mg metronidazole or 1.2g Augmentin intravenously. Those patients with gangrenous or perforated appendices received eight additional doses of the trial drug at 8 hourly intervals. Overall there were 13 wound infections in the Augmentin group (11 per cent) and 21 in the metronidazole group (18 per cent). The 90 per cent confidence limits for the overall 7 per cent difference in infection rates were +/- 8.5 per cent. There were high rates of wound infection in the gangrenous group (Augmentin 8 per cent versus metronidazole 19 per cent) and especially in the perforated group (Augmentin 33 per cent versus metronidazole 63 per cent). There was no statistically significant difference between the infection rates with the two antibiotics but our study suggests that Augmentin, which is active against both aerobes and anaerobes, may be more effective than metronidazole in reducing wound sepsis after appendicectomy.
 ...
PMID:Metronidazole and Augmentin in the prevention of sepsis after appendicectomy. 401 43

The use of chemoprophylaxis in major Head and Neck surgery is controversial. Prior to conducting a prospective trial a controlled microbiological monitoring of 32 patients was performed to determine a suitable antibiotic for prophylaxis. Wound infection occurred in 22 (68%) patients with fistulae occurring in 10 of these patients (45.5%). Pre-operative cultures were of limited value in predicting subsequent sepsis. Gram-negative aerobic bacilli were the commonest group of pathogens (34.4%) isolated post-operatively. From projected resistance profiles of pathogenic and opportunistic bacteria amoxycillin and clavulanic acid (Augmentin, Beecham Pharmaceuticals) was chosen as a suitable antibiotic.
 ...
PMID:Bacteriological assessment of patients undergoing major head and neck surgery. 646 49

Wound infections are a significant complication following major oncological head and neck surgery. In view of the controversy surrounding the use of chemoprophylaxis a controlled trial was designed. Intravenous Augmentin (amoxycillin and clavulanic acid) was shown to reduce significantly (P less than 0.025) the incidence of postoperative sepsis.
 ...
PMID:Chemoprophylaxis in major head and neck surgery. 651 2

In a series of 44 patients with lower limb ischaemia requiring amputation for major limb sepsis, the performance of a new antibiotic combination with beta-lactamase-inhibiting properties, amoxycillin plus clavulanic acid (A-CA) (Augmentin; Beecham), was compared with that of penicillin in the prevention of wound infection. The sepsis rate of 12,9% in the group of patients receiving peri-operative A-CA was significantly lower than the 76,9% in the penicillin control group (x2 = 14,48; P less than 0,001). It is concluded that there is a need for peri-operative antibiotic cover in this situation and that A-CA appears to be highly effective. No statistical difference was found as regards development of sepsis in wounds closed primarily or left open while under A-CA cover.
 ...
PMID:Prevention of wound sepsis in amputations by peri-operative antibiotic cover with an amoxycillin-clavulanic acid combination. 684 68

In a series of 64 patients requiring amputation for lower limb sepsis, the performance of a new antibiotic combination with beta-lactamase-inhibiting properties, amoxycillin plus clavulanic acid (A-CA) (Augmentin; Beecham) in the prophylaxis of postoperative wound sepsis, was compared with that of a combination of amoxycillin and ampicillin (A-A) (Suprapen; Bencard) and a control group. The sepsis rate following A-CA prophylaxis (12,9%) was significantly less than in the control group (x 2 = 18, 49; P less than 0,001). Although not attaining statistical significance (x 2 = 2, 12),, A-CA compared favourably with A-A (sepsis rate 35.3%) in the prevention of post-amputation wound sepsis. There was no statistically significant difference in the development of sepsis between wounds closed primarily and those left unsatured while under A-CA cover. It is concluded that peri-operative antibiotic cover for amputations in septic lower limb lesions is advisable and that A-CA is a valuable antibiotic in this situation.
 ...
PMID:Peri-operative antibiotic cover in amputations using an amoxycillin-clavulanic acid combination. 708 7

Thirty-two patients with skin infections were treated with Augmentin, a combination of amoxycillin with the beta-lactamase inhibitor clavulanic acid. These infections were primary skin sepsis (7), infected eczema (11), infected trauma (10) and leg ulcers (4). The majority of cases were caused by amoxycillin-resistant Staphylococcus aureus either alone or in combination with Streptococcus pyogenes. Thirty patients (94%) responded to treatment with only one withdrawal (for side effects). Side effects were limited to nausea (9%) diarrhoea (9%) and rash (3%). No patient with diarrhoea showed evidence of Clostridium difficile toxin production in the stools. Augmentin appears to be a safe, useful, effective antibiotic for the treatment of skin infections in general practice and in hospital. It may prove of particular value when mixed infections of penicillin-resistant staphylococci and Streptococcus pyogenes are present.
 ...
PMID:Further experience with augmentin in the treatment of skin infections. 716 11

Augmentin as single agent was compared to the combination of metronidazole/gentamicin in the prevention of sepsis after appendicectomy. Two hundred patients admitted to Riyadh Central Hospital with a clinical diagnosis of acute appendicitis were enrolled in a prospective randomized study. All patients had a preoperative chest X ray, CBC, urinalysis and any other necessary investigations. Patients received either drug regime intravenously, 30 min prior to surgery. The overall incidence of wound infections in the Augmentin group was 8% as compared to 14% in the metronidazole/gentamicin group. There were no intra-abdominal abscesses in either group. Patients with perforated or gangrenous appendices received a 3- to 5-day course of treatment. All the early wound infection (2-4 days after operation) occurred in patients with gangrenous or perforated appendices. The results were studied statistically using chi 2 and there was no statistically significant difference between the infection rates in the two treatment groups whatever the state of the appendix at operation. Augmentin is as effective and well-tolerated as metronidazole/gentamicin in the prevention of wound infection following appendicectomy. The ease of administration of one drug with added anti-anaerobic property makes Augmentin superior to the tested combination.
 ...
PMID:Comparative study of augmentin versus metronidazole/gentamicin in the prevention of infections after appendicectomy. 848 7


1 2 3 Next >>