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Perioperative Antibiotic Prophylaxis in General Thoracic Surgery H. wertzet ' , L. S tooboda l , A. Joos-wurtemberqer l, U. Fran k e, and .LHosse ! I Depa rtment of Pulmonary Su rge ry 2Dep artm ent of Hospi tal Epide miology. Univers ity Hos pital. Frci burg. Germ any

A prospective study of the efficacy of ampicillin in combinatio n with su lba ctam . a p· lactama se inhibitor. (,VS) in peri operativ e prop hylaxis was perfor med . The study cons isted of two inde pe nde nt parts perfor med at the same time . Pa rt I included 60 patients with lobectomi es an d seg men tectomies . Gro up A (AI S 1 x 3 g "single sho e ) was com pa re d with group B (NS 3 x 3 g). Sup erficial wo un d infectio ns occ urred in 3 patients of gro u p A a nd in 2 patien ts of gro up B. Th ere wa s no e mpyema . Brunchit ls a nd pneu mon ia we re found in 10 pa tie nts of gro up A and in 7 pati en ts of gro up B. Pa rt II exa mined 25 pn eumonectomie s receiving NS 3 x 3 g for 3 days . Conce ntrations of a mpicillin a nd s ulbacta m in ser um and lung tissue we re dete rmined and s howed ad equate levels to CO pt) with us ua l ba cter ia in lun g surgery. Th er e was one superficial wound infection. 2 ca ses of bronchitis. an d 2 cases of pn eumonia . Key words Per ioperative a ntibiotic prophylaxis - Ampicillin - Sulba ctam Pulmon ary s urge ry - Postoperat ive infection

Introdu ction Peri ap erative antibiotic prophylaxis (PX) is a well esta blished a nd ca nfir med procedure in genera l surgery. Pulmonary resections are classified as "clean-conta minated". Withaut PX th e incid ence of wound infections after pulmonary surgery is approx. 10 % (2). Open ing of the bronchial tr ee dur ing surgery is an importa nt factor for the pathogenesis of postoperati ve wound infections. Thus , it is of gr eat imp ort an ce to ma intain adequate se rurn and tissu e levels af the antibiotic during this vulne ra ble peri od. i. e. when contamination with bacterial path ogens is most likely to accur (2). In daily practice. the duratian of PX still dilTers . Long term PX. however. until removal of all drains or even until discharge of the pa tient. is no longer recomm ended . Rou-

Present ed in part at the 2 1st Annual Meeti ng of the Gennan Society for Thoracic and Cardiovascular Surgery Febru ary 19 - 22. 19 92. Bonn

Pert eperntive Antlblotlka- Pruphylax e in der Allgeme ine " Tho raxchir u rgie Es wur de c ine prospek tive Studic tiber d ie \ Virksa mkeit von Amp icillin in Kombina tion mit Sulbactam . einem Beta -Lactamase- Inhi bitor (UNACID

Perioperative antibiotic prophylaxis in general thoracic surgery.

A prospective study of the efficacy of ampicillin in combination with sulbactam, a beta-lactamase inhibitor, (A/S) in perioperative prophylaxis was pe...
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