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Biomedical subjects

T Dørflinger

Publications and source records attributed to T Dørflinger.

26 records · Page 2Linked to original sources
PubMed1985

The role of antibacterial prophylaxis in urologic surgery.

The possible origins of post-TUR bacteriuria (urethral flora, prostate, bladder tumors, or contaminated irrigating fluids or instruments) are discussed. A review of the literature on antibacterial prophylaxis during TUR led to a positive assessment of its value. Preferred agents for prophylaxis of urinary tract infections include cephalosporins, extended-spectrum penicillins, ampicillin, and aminoglycosides. The value of antibacterial prophylaxis in open urologic surgery, such as prostatectomy, has not yet been clearly established, but studies have demonstrated significant benefit in patients undergoing transrectal needle biopsy of the prostate. New techniques of stone removal have not yet been thoroughly evaluated with respect to their potential for causing urinary tract infection and bacteremia. Since as many as 77 per cent of stones harbor bacteria, however, antibiotic prophylaxis is recommended. Nonurologic indications for antibacterial prophylaxis are outlined.

Anti-Bacterial Agents↗
PubMed1985

Infectious complications after instrumentation of urinary tract.

Urethral catheterization is the single most important predisposing factor in the development of nosocomial urinary tract infection. Infection rates, etiologies, and possible methods of prevention are reviewed. Cystoscopy may be followed by a transient bacteremia. It is recommended that patients with positive urine cultures who undergo diagnostic cystoscopy receive antibiotic prophylaxis, but this is not required in patients with sterile urine. The incidence of urinary tract infection following transurethral surgery in patients who have not been given prophylactic antibiotics ranges from 6 to 60 per cent. The value of antibacterial prophylaxis in TUR, is still somewhat controversial. The incidence of infection and the value of antibacterial prophylaxis in prostatic biopsy appear to be related to the technique (transperineal or transrectal) used for the biopsy. It is too early to assess the infection risks associated with relatively new urologic procedures, such as ureteroscopy and percutaneous nephrostomy. Nevertheless, any procedure that crushes or manipulates a potentially bacteria-harboring stone carries at least a theoretical risk of infection.

Bacterial Infections↗
PubMed1984

Distribution of ciprofloxacin in the dog prostate and various tissues.

The distribution in the dog prostate and other tissues of ciprofloxacin, a quinoline carboxylic acid derivative, was investigated in an experimental model. The concentrations in prostatic tissue, prostatic interstitial fluid (PIF), and prostatic secretion (PS) were lower than the corresponding plasma (P) concentrations, as would be expected for an acidic compound. The experiments were carried out under steady state conditions during intravenous infusion in one group of dogs and following gastric administration in another group. During steady state the ciprofloxacin concentrations were significantly higher in PS than in PIF, and the median PS/P ratios were significantly higher than the PIF/P ratios. These concentrations and ratios were compared with those of two other quinoline carboxylic acid derivatives, rosoxacin and norfloxacin. The concentrations of ciprofloxacin in prostatic tissue, PIF, PS, and urine were several times higher than the minimum inhibitory concentrations for most gram-negative pathogens that cause bacterial prostatitis and urinary tract infections. Clinical trials of ciprofloxacin in these diseases are therefore indicated.

4-Quinolones↗
PubMed1984

Antibiotic prophylaxis in transurethral surgery.

In a prospective randomized double-blind study, perioperative prophylaxis with cefoperazone, a third-generation cephalosporin, in transurethral surgery was evaluated. Cefoperazone significantly lowered the urinary tract infection rate from 17 per cent to 0 per cent, five to seven days postoperatively. Results from the latest placebo-controlled studies concerning antibiotic prophylaxis in transurethral surgery are summarized, and the use of antibiotic prophylaxis is discussed and recommended.

Aged↗
PubMed1984

Candicidin in treatment of benign prostatic hypertrophy.

In a prospective, double-blind, placebo-controlled multicenter study, candicidin (a polyene macrolide) was investigated in the treatment of benign prostatic hypertrophy. Seventy-six patients were included in the study--34 in the candicidin group and 42 in the placebo group. Patients treated with 270 mg. of candicidin daily for 6 months had a significant decrease in residual urine, voided volume and bladder volume. No significant increases were found in flow rates. Symptoms improved significantly in both the candicidin and the placebo group, but no differences in improvement were found between the groups. The results of candicidin treatment are less satisfactory than those following surgery.

Antifungal Agents↗
PubMed1984

Absorbable suture in hernia repair.

In a randomized, double-blind study, comparison was made between absorbable polyglycolic acid sutures (Dexon) and non-absorbable sutures (Dacron) in inguinal and femoral herniorrhaphies. The study comprised 58 patients with 61 hernias. Bassini repair was done in inguinal hernia and McVay repair in femoral hernia. The patients were evaluated at a follow-up examination six months after the operation. There was no wound dehiscence or infection during the primary admission. In one patient from each group there was recurrence of hernia during the observation period. No suture granuloma had developed in that time. These results warrant the use of absorbable sutures in inguinal and in femoral herniorrhaphy.

Absorption↗
PubMedDate not supplied

Antibiotic prophylaxis in transurethral surgery: a comparison of sulbactam-ampicillin and cefoxitin.

The efficacy and safety of perioperative prophylaxis with sulbactam-ampicillin or cefoxitin was compared in a prospective randomized double-blind study of 103 patients undergoing transurethral surgery. Fifty-two patients received 0.5 g sulbactam and 1 g ampicillin intramuscularly, 30 to 90 minutes prior to surgery, followed by the same dose administered intravenously every eight hours for a total of three additional doses over 24 hours. Fifty-one patients received 1 g of cefoxitin administered according to the same schedule as sulbactam-ampicillin. The incidence of urinary tract infection during hospitalization was 8% in the sulbactam-ampicillin group and 4% in the cefoxitin group. One month postoperatively the incidences were 3% and 5%, respectively. There was no significant difference between the groups in incidence of fever or length of postoperative hospital stay. Both drugs were well tolerated. No side effects were seen other than a mild skin rash in one patient and diarrhea in two patients. Sulbactam concentrated in prostatic tissue, and ampicillin together with sulbactam was found in concentrations above the minimal inhibitory concentration of most bacteria causing postoperative urinary tract infection. It is concluded that sulbactam-ampicillin and cefoxitin are equally effective and safe in preventing postoperative urinary tract infection in transurethral surgery.

Adult↗