소아비뇨기과 통원수술 환자에서 예방적 항생제 사용의 임상지침 확립을 위한 연구
Trial for Clinical Guideline of the Use of Prophylactic Antibiotics in Pediatric Urologic Outpatient Surgery
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Purpose: Proper use of antibiotics is essential in the clinical field. The overuse of antibiotics can be one of the causes for resistance. However, there is a lack of guideline to a valid method of prophylactic antibiotics in surgery. We evaluated the evidence on the suitable prophylactic antibiotics usage to prevent perioperative infection, when performing pediatric urologic outpatient surgery. Materials and Methods: From December 2010 to may 2011, 70 cases (mean age was 3.5±3.23 years)who underwent outpatient operation approached inguinal or scrotal incision were evaluated. In group 1, intravenous antibiotic prophylaxis was done only preoperatively. In group 2, intravenous antibiotics were administrated pre- and post-operative, each. In group 3, beside pre- and post-operative intravenous antibiotic prophylaxis, additional oral antibiotics were medicated for 3 days after discharge from the hospital. Further, in group 4, beside pre- and post-operative intravenous antibiotic prophylaxis, oral medication was administered until 7 days after discharge. Skin redness, pain, wound dehiscence, fever, gastrointestinal disturbance,and etc., were examined postoperatively. Results: Slight skin redness was observed in 4 cases (23.5%), 2 cases (10.5%), 1 case (7.1%), and 0case (0.0%) in each group, but there is no need to treatment. There is no case who feels pain on the incision site of each group. Wound dehiscence occurred in one case in group 1 (5.9%) and group 3 (7.1%),respectively. There were no association with wound infection between each group, and wound infection was recovered spontaneously. Two cases (11.8%), 1 case (5.3%), 0 case(0.0%), and 3 cases (15.0%) complained with fever in each group. Diarrhea was observed in 2 cases (13.3%) and 4 cases (20.0%) in group 3 and 4, respectively. Conclusions: There were no differences in prophylactic effect to prevent infection in each group. Group 1 showed a lower incidence of diarrhea than group 3 or 4, but other adverse effects were not different among the groups. Therefore, it is sufficient to use antibiotics preoperatively for prophylactic purpose in pediatric urologic outpatient surgery.
Abstract
Purpose: Proper use of antibiotics is essential in the clinical field. The overuse of antibiotics can be one of the causes for resistance. However, there is a lack of guideline to a valid method of prophylactic antibiotics in surgery. We evaluated the evidence on the suitable prophylactic antibiotics usage to prevent perioperative infection, when performing pediatric urologic outpatient surgery. Materials and Methods: From December 2010 to may 2011, 70 cases (mean age was 3.5±3.23 years)who underwent outpatient operation approached inguinal or scrotal incision were evaluated. In group 1, intravenous antibiotic prophylaxis was done only preoperatively. In group 2, intravenous antibiotics were administrated pre- and post-operative, each. In group 3, beside pre- and post-operative intravenous antibiotic prophylaxis, additional oral antibiotics were medicated for 3 days after discharge from the hospital. Further, in group 4, beside pre- and post-operative intravenous antibiotic prophylaxis, oral medication was administered until 7 days after discharge. Skin redness, pain, wound dehiscence, fever, gastrointestinal disturbance,and etc., were examined postoperatively. Results: Slight skin redness was observed in 4 cases (23.5%), 2 cases (10.5%), 1 case (7.1%), and 0case (0.0%) in each group, but there is no need to treatment. There is no case who feels pain on the incision site of each group. Wound dehiscence occurred in one case in group 1 (5.9%) and group 3 (7.1%),respectively. There were no association with wound infection between each group, and wound infection was recovered spontaneously. Two cases (11.8%), 1 case (5.3%), 0 case(0.0%), and 3 cases (15.0%) complained with fever in each group. Diarrhea was observed in 2 cases (13.3%) and 4 cases (20.0%) in group 3 and 4, respectively. Conclusions: There were no differences in prophylactic effect to prevent infection in each group. Group 1 showed a lower incidence of diarrhea than group 3 or 4, but other adverse effects were not different among the groups. Therefore, it is sufficient to use antibiotics preoperatively for prophylactic purpose in pediatric urologic outpatient surgery.
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