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Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Single dose administration of antibiotics prior to vaginal hysterectomy was found to be an efficient and safe way of providing prophylaxis against infection. Metronidazole was as efficient as ampicillin in achieving a significant reduction in major morbidity, pelvic sepsis, and the "quantity" of postoperative fever. Antibiotic prophylaxis reduced hospital stay by an average of 3 days.
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PMID:Simplified antibiotic prophylaxis for vaginal hysterectomy. 29 41

In a study carried out with 565 patients undergoing gynaecological and general surgical procedures, metronidazole ('Flagyl') was used pre- and post-operatively and the incidence of post-operative infection, particularly that due to anaerobic organisms, was recorded. This was not a controlled study but, by comparison with other series, it would appear that the use of oral metronidazole had substantially reduced the likelihood of supervention of anaerobic sepsis. It is probable that the use of intravenous metronidazole therapy would have reduced the incidence of anaerobic sepsis still further had this preparation been available at the time.
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PMID:Multicentre study of 'Flagyl' in the prevention of post-operative anaerobic infection. 36 22

Clinical trials were carried out in order to determine the value of metronidazole in preventing the development of anaerobic infections after surgery. Following a successful controlled trial of hysterectomy patients, among whom the prophylactic use of oral metronidazole resulted in a reduction of the anaerobic sepsis rate from 25% to nil, further trials were carried out with patients having urgent appendicectomy, those having elective colonic surgery and pregnant women having delivery by the vaginal and caesarean routes. These studies were conducted as double-blind trials in which metronidazole was compared with a placebo; patients were randomly allocated to the two "drug" groups. Since completion of the hysterectomy trial over 618 hysterectomies have been performed under metronidazole cover, none of which were complicated by anaerobic sepsis. Among appendicectomy patients, anaerobic infection did not develop in any of the 49 patients who received prophylactic metronidazole, but bacteriologically confirmed clinical anaerobic infections developed in 9 (19%) of 46 control patients. Since completion of the trial over 1098 appendectomies have been performed under metronidazole cover, only two of which developed an anaerobic infection. Among colonic surgery patients, anaerobic infections did not develop in any of 27 patients who received prophylactic metronidazole, but bacteriologically confirmed clinical anaerobic infections developed in 11 (58%) of 19 control patients. Since completion of the trial over 126 colonic operations have been performed under metronidazole cover, none of which were complicated by anaerobic sepsis. Pregnant women having vaginal delivery were not especially prone to anaerobic infections so that metronidazole prophylaxis is not indicated in these patients. Delivery by caesarean section appears to carry a risk of post surgical anaerobic sepsis in about 20% of patients not protected with metronidazole prophylaxis. Metronidazole is regarded as the drug of choice for the treatment of those non-clostridial anaerobic infections that require antimicrobial therapy. It may be given orally, rectally, intravenously and topically, has virtually no side effects and its use is characterized by a strikingly rapid and sustained clinical and microbiological response.
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PMID:Metronidazole in the prevention and treatment of anaerobic sepsis. 39 31

The antimicrobial activity of 24 Bacteroides fragilis, 13 Bacteroides thetaiotaomicron and 5 Bacteroides vulgatus, all of which were recent clinical isolates, was determined by the agar dilution technique. These three species had similar susceptibility patterns, but the B. thetaiotaomicron strains were generally less susceptible than the B. fragilis strains. Clindamycin was very active against 81% of the Bacteroides strains at 3.1 mcg/ml of less while 21% of the Bacteroides strains had MICs of 100 mcg/ml or above. Metronidazole was active against all Bacteroides strains at 1.6 mcg/ml or less. The patients with decubitus ulcers and B. fragilis septicemia, who responded satisfactorily to the combination of metronidazole and tobramycin, were presented.
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PMID:[Bacteriological and clinical studies on metronidazole in Bacteroides fragilis infections (author's transl)]. 43 90

Fifty patients with anaerobic sepsis were treated with intravenous and oral metronidazole. In 26 cases this was combined with other antimicrobial agents. Highly satisfactory clinical results were obtained in most patients, though in many surgical drainage was also essential. No side effects or thrombophlebitis were seen. Mixed growths of anaerobic and aerobic bacteria were isolated from all except five patients, who produced only anaerobes. Metronidazole is the only available antimicrobial agent providing selective activity against anaerobic organisms. It is effective and safe and is usually the drug of choice for treating severe anaerobic sepsis.
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PMID:Metronidazole and anaerobic sepsis. 100 57

Prophylactic appendicectomy was performed on 56 consenting patients undergoing elective cholecystectomy. The control group consisted of 60 patients. Both groups were well matched in respect of age, sex, build and type of incision. All patients received a single i.v. dose of 1 g Cefazolin sodium and 500 mg Metronidazole at induction of anaesthesia. Postoperative wound sepsis occurred in 5.4% of the appendicectomy group and in 6.7% of the control group. Residual intra-abdominal sepsis did not occur in either group. The mean duration of postoperative hospital stay was 9.1 days (SD +/- 1.63) in the appendicectomy group and 8.5 days (SD +/- 1.85) in the control group. These differences were not statistically significant. Six (10.7%) of the appendices removed were abnormal, including two with inflammation. The conclusion of this study is that prophylactic appendicectomy can be performed safely during elective cholecystectomy provided that it is done without undue manipulation and the patient is protected with an effective prophylactic antibiotic regimen.
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PMID:Prophylactic appendicectomy during elective cholecystectomy: effects on morbidity. A prospective controlled study. 270 95

Metronidazole, a nitroimidazole derivative, is a unique antimicrobial agent that is active against both bacterial and parasitic organisms, although only the anaerobic members of these groups are susceptible. It has been used for the treatment of trichomoniasis for almost 30 years and is also effective in amebiasis and giardiasis. More recently, metronidazole has emerged as a principal agent for the treatment of anaerobic infections. It is highly effective against all species of anaerobes except certain non-spore-forming gram-positive bacilli and cocci and is the only agent rapidly bactericidal against the Bacteroides fragilis group. The hydroxy metabolite is 65% as effective as metronidazole and may play a major therapeutic role. Clinical studies have substantiated its efficacy for prophylaxis during elective colorectal surgical procedures and the treatment of deep abdominal sepsis (usually in combination with another agent such as an aminoglycoside). Metronidazole is the treatment of choice for bacterial vaginosis and seems to be as effective as vancomycin for treatment of Clostridium difficile-related diarrhea and colitis. Good blood levels are produced after both oral and intravenous administration, and side effects are infrequent and minimal. Metronidazole should not be taken during the first trimester of pregnancy because of concerns about mutagenicity. Tinidazole and ornidazole are recently developed nitroimidazole derivatives that have even greater antimicrobial activity than metronidazole.
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PMID:Symposium on antimicrobial agents. Metronidazole. 331 51

The Gardnerella vaginalis-infection of the urogenital tract is of clinical importance in females and of epidemiological importance in males. Females suffer from Bacterial Vaginosis, with a foul-smelling grey vaginal discharge with a pH of 5.0-5.5 which contains "clue cells", and from Sepsis. The isolation and identification of G. vaginalis i necessary in man. If G. vaginalis-infection is suspected, simultaneous infections with further STD-agents such as N. gonorrhoeae, C. trachomatis etc should be excluded. Metronidazole (1 g/day for 5 days) is the drug of choice in G. vaginalis-infection.
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PMID:[Gardnerella vaginalis infection. Clinical aspects, diagnosis and therapy]. 331 83

Bacteroides fragilis is a rare cause of bacterial meningitis. In the antibiotic era nine cases have been reported. Seven of these nine cases occurred in premature infants and neonates. Of the nine patients with B. fragilis meningitis, two died, four survived with neurologic sequelae, and three survived without sequelae. Predisposing conditions included abdominal sepsis, chronic otitis media, and ventriculoatrial shunt infection. Metronidazole, which is bactericidal, has been the most effective therapy for B. fragilis meningitis.
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PMID:Bacteroides fragilis meningitis. 233 Apr 83

Metronidazole suppositories have previously been shown to be superior to povidone iodine intraoperative wound spray in reducing postappendicectomy wound sepsis. In subsequent studies metronidazole suppositories and cefotaxime injections reduced the sepsis rate to 9.3%, while the same combination produced a wound sepsis rate of 7.6% compared with 17.2% for cefotaxime alone. In an ongoing study, metronidazole and cefotaxime are now being compared with piperacillin in a single-blind trial. Adult patients undergoing emergency appendicectomy in Nottingham have been included in this study, which has ethical committee approval. When the decision to perform emergency appendicectomy was made, the patient was randomly allocated a numbered pack. This contained either 3 x 1g injections of cefotaxime and 6 x 1g metronidazole suppositories or 3 x 2g injections of piperacillin and 6 placebos. 40 minutes before operation the patient received the first suppository and the remainder every 8 hours. The patient received the first injection of antibiotic by intravenous or intramuscular injection and the remaining doses 8 and 16 hours later. A wound was regarded as infected if pus discharged either spontaneously or on incision. 175 patients have been studied to date. The treatment groups were well matched for age and sex. Seven of the 77 patients in the cefotaxime/metronidazole group (9.1%) compared with 12 of the 76 in the piperacillin group (15.8%) have developed wound infections. This study confirms that the combination of cefotaxime and metronidazole seems to be more effective than piperacillin alone in the reduction of postappendicectomy wound sepsis. Currently cefotaxime plus metronidazole is the therapy of choice.
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PMID:Cefotaxime plus metronidazole appears more effective than piperacillin in the prevention of postappendicectomy wound sepsis. Preliminary results of a comparative trial. 339 72


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