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Otolaryngolog Head and Neck Surgery - part 7

có thêm một chi phí đáng kể và giá trung bình là 4 ngày thêm thời gian nằm viện. Kháng sinh có hiệu quả trong việc giảm tỷ lệ mắc các bệnh nhiễm trùng như vậy, ngay cả trong trường hợp tác "sạch", khi các loại thuốc được lựa chọn và quản lý (mặc dù trong sạch otologic và phẫu thuật mũi, | SECTION IV ANTIMICROBIAL PROPHYLAXIS1 An estimated 5 to 10 percent of hospitalized patients acquire a nosocomial hospital infection which adds a substantial cost and an average of 4 extra days to the hospital stay. Antibiotics are effective in reducing the incidence of such infections even in clean operative cases when the drugs are properly selected and administered although in clean otologic and nasal surgery infections are so infrequent that data may not justify prophylaxis . Patients should be selected for prophylaxis if the medical condition or the surgical procedure is associated with a considerable risk of infection or if a postoperative infection would pose a serious hazard to the patient s recovery and wellbeing.2 CIRCUMSTANCES IN WHICH PROPHYLAXIS MAY OR MAY NOT BE RECOMMENDED 1. Streptococcal pharyngitis contacts culture and or treat amoxicillin clindamycin etc. 2. Otitis media prophylaxis is recommended for high risk children such as Eskimos and Native Americans and those with cleft palates. Additionally it may be appropriate for children who suffer over four episodes of acute otitis media per year but clear their middle ears of fluid between episodes.3 However widespread prolonged use for months in low doses probably is a causal factor in emergence of resistant bacteria.3 Frequent recurring acute otitis media Use amoxicillin see page 26 Section II in a single daily dose V4 to V2 of full therapeutic daily doses throughout the infection season. Preferably the pulse method utilizes full therapeutic doses at the earliest onset of cold symptoms given until they clear. 3. Lengthy elective surgery in clean operative fields see following. 4. Intranasal packing for epistaxis or surgery Use infection-resistant or antibiotic-impregnated packing and give IV antistaph. agent i.e. cefazolin ampicillin sulbactam or clindamycin pre op.4 CIRCUMSTANCES IN WHICH PROPHYLAXIS IS USUALLY RECOMMENDED 1. Hemophilus influenzae type B infections epiglottitis cellulitis .