New PDF release: Antimicrobial Prophylaxis in Urology with special reference

By Thomas C. Gasser M.D. (auth.)

This monograph provides a good evaluation of the problem of antimicrobial prophylaxis in urol­ ogy and using the recent fluoroquinolones in urology. the advance of the fluoro­ quinolones has had a profound influence in urology, in particular due to the specific phar­ macokinetics of the fluoroquinolones with their or extra pK values, making concen­ tration of those compounds attainable within the prostate. Their huge spectra opposed to infecting organisms inflicting infections within the urinary tract have additionally made them well known and virtually excellent within the remedy of urinary tract infections. This thesis summarizes in an concise approach and brings modern essentially all our understand­ ledge in regards to the use of fluoroquinolones in urology. The bankruptcy on antimicrobial prophylaxis covers our current wisdom thoroughly, specifically about the use of those medications in antimicrobial prophylaxis in transurethral surgical procedure. September 1992 PaulO. Madsen Madison, Wisconsin, united states v Contents Preface. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . V I. creation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1. 1. Author's courses noted in textual content . . . . . . . . . . . . . . . . . . . . . . 1 1. 2. historic heritage . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 1. three. difficulties of Antimicrobial Prophylaxis in Urology . . . . . . . . . . . . . . . . 2 D. basic issues . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three 2. 1. Definitions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three 2. 1. 1. Bacteriuria and urinary tract infections . . . . . . . . . . . . . . . . . . . . . . three 2. 1. 2. Bacteremia and septicemia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . three 2. 1. three. Nosocomial infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . four 2. 1. four. Wound infections . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . five 2. 2. Pathophysiology of an infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . five 2. three. Specifics of Antimicrobial brokers for use in Prophylaxis . . . . . . . . . . 6 2. four. function of Quinolones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. four. 1. Antimicrobial job . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 2. four. 2. Pharmacokinetic homes . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

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2. Patient characteristics predisposing to infection In general, females, older individuals, and those with a medical history of recurrent UTI or prostatitis, and pregnancy are at higher risk for infection (Haley et al. , 1981a). , 1985b). , 1980). 4 % in patients with severe malnutrition. Similar percentages have been reported in the Foothill hospital study (Cruse and Foord, 1980). Immunocompromized patients are at risk for bacterial infection, particularly if the granulocyte count is below 1500/mm3 (Rubin and Young, 1988).

J. Med. 291: 215-219, 1974. Garibaldi, R. , Burke, J. , Britt, M. , Miller, W. , Smith, C. : Meatal colonization and catheterassociated bacteriuria. N. Eng!. J. Med. 303: 316-318, 1980. Gasser, T. , Graversen, P. : Antimicrobial prophylaxis in surgery. N. Eng!. J. Med. 316: 1089, 1987. Gasser, T. : Low bacteremia risk during extracorporeal shock wave lithotripsy. Br. J. Uro!. (in press) Gasser, T. , Madsen, P. : Influence of urological irrigation fluids on urothelial bacterial adherence. (submitted for publication).

12: 12-19, 1990. Kunin, C. : Prevention of catheter-induced urinary-tract infections by sterile closed drainage. N. Engl. J. Med. 274: 1155-1161, 1966. 34 Kyriakides, G. , Simmons, ~. , Najarian, J. : Wound infections in renal transplant wounds: Pathogenetic and prognostic factors. Ann. Surg. 182: 770-775,1975. , Diokno, A. , Lowe, B. , Kalish, M. : Followup on unsterile intermittent self-catheterization. J. Urol. 111: 184-187, 1974. Larsen, E. , Gasser, T. : Antimicrobial prophylaxis in urologic surgery.

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