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However, an evaluation of the need for pre-operative antimicrobial prophylaxis for ESD-ECN has yet to be reported. The objective of this study was to determine whether pre-operative antimicrobial prophylaxis is associated with a reduced incidence of post-operative infection following ESD-ECN. Methods The present retrospective case-controlled study utilized a database built from the medical records of 14 university hospitals throughout Japan. Patients who were admitted and discharged from the hospital from April 2012 to October 2013 and who had undergone ESD-ECN were included in the study. Patients who had been undergone any other operation during their course of hospitalization, and patients who were prescribed antimicrobial agents for reasons other than post-operative infection or for prophylaxis were excluded. Characteristics of the study population, pre-operative antimicrobial prophylaxis and antimicrobial therapy for post-operative infection were investigated. In addition, we compared the characteristics of patients with post-operative infection (PI) and those with no post-operative infection (NPI). Univariate analyses were used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI). Results and discussion We obtained the records of 522 patients who had undergone ESD-ECN from the database. After application of exclusion criteria, 421 patients were enrolled. The post-operative infection rate was 1・2%. Peritonitis was found most to be the most common post-operative infection (44%). Pre-operative antimicrobial prophylaxis was used for 314 patients (75%), with a median duration of 3・0 (range 1-11) days. Cefotiam was most frequently prescribed for pre-operative antimicrobial prophylaxis (56%). Antimicrobial therapies were started 1-10 days after ESD-ECN for a duration of 1-14 days. Pre-operative antimicrobial prophylaxis was not associated with post-operative infection rate, with an OR (95% CI) of 0・73 (0・08-6・61). However, digestive tract perforation was shown to be associated with post-operative infection and had an OR (95% CI) of 17・1 (1・66-176・45). What is new and conclusion Post-operative infection is an exceedingly rare event following ESD-ECN. Pre-operative antimicrobial prophylaxis had no significant effect on post-operative infection following ESD-ECN and thus may be unnecessary. Instead, prevention of digestive tract perforation may be more critical for the decrease in post-operative infections. 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Post-operative infection of endoscopic submucosal dissection of early colorectal neoplasms: a case?controlled study using a Japanese database
http://hdl.handle.net/10069/35885
http://hdl.handle.net/10069/35885de988a50-32c5-4d57-bf6d-f853e9935341
名前 / ファイル | ライセンス | アクション |
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JCPT40_573.pdf (181.5 kB)
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Item type | 学術雑誌論文 / Journal Article(1) | |||||
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公開日 | 2016-11-01 | |||||
タイトル | ||||||
タイトル | Post-operative infection of endoscopic submucosal dissection of early colorectal neoplasms: a case?controlled study using a Japanese database | |||||
言語 | ||||||
言語 | eng | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | antibiotic prophylaxis | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | pharmacoepidemiology | |||||
キーワード | ||||||
主題Scheme | Other | |||||
主題 | surgical wound infection | |||||
資源タイプ | ||||||
資源タイプ識別子 | http://purl.org/coar/resource_type/c_6501 | |||||
資源タイプ | journal article | |||||
著者 |
Muro, Takahiro
× Muro, Takahiro× Higuchi, Norihide× Imamura, Masanobu× Nakagawa, Hiroo× Honda, Masayuki× Nakao, Kazuhiko× Izumikawa, Koichi× Sasaki, Hitoshi× Kitahara, Takashi |
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抄録 | ||||||
内容記述タイプ | Abstract | |||||
内容記述 | What is known and objective Endoscopic submucosal dissection of early colorectal neoplasms (ESD-ECN) is known to be an operation with risk of contamination, possibly requiring pre-operative antimicrobial prophylaxis for the prevention of post-operative infection. However, an evaluation of the need for pre-operative antimicrobial prophylaxis for ESD-ECN has yet to be reported. The objective of this study was to determine whether pre-operative antimicrobial prophylaxis is associated with a reduced incidence of post-operative infection following ESD-ECN. Methods The present retrospective case-controlled study utilized a database built from the medical records of 14 university hospitals throughout Japan. Patients who were admitted and discharged from the hospital from April 2012 to October 2013 and who had undergone ESD-ECN were included in the study. Patients who had been undergone any other operation during their course of hospitalization, and patients who were prescribed antimicrobial agents for reasons other than post-operative infection or for prophylaxis were excluded. Characteristics of the study population, pre-operative antimicrobial prophylaxis and antimicrobial therapy for post-operative infection were investigated. In addition, we compared the characteristics of patients with post-operative infection (PI) and those with no post-operative infection (NPI). Univariate analyses were used to estimate the odds ratios (OR) and 95% confidence intervals (95% CI). Results and discussion We obtained the records of 522 patients who had undergone ESD-ECN from the database. After application of exclusion criteria, 421 patients were enrolled. The post-operative infection rate was 1・2%. Peritonitis was found most to be the most common post-operative infection (44%). Pre-operative antimicrobial prophylaxis was used for 314 patients (75%), with a median duration of 3・0 (range 1-11) days. Cefotiam was most frequently prescribed for pre-operative antimicrobial prophylaxis (56%). Antimicrobial therapies were started 1-10 days after ESD-ECN for a duration of 1-14 days. Pre-operative antimicrobial prophylaxis was not associated with post-operative infection rate, with an OR (95% CI) of 0・73 (0・08-6・61). However, digestive tract perforation was shown to be associated with post-operative infection and had an OR (95% CI) of 17・1 (1・66-176・45). What is new and conclusion Post-operative infection is an exceedingly rare event following ESD-ECN. Pre-operative antimicrobial prophylaxis had no significant effect on post-operative infection following ESD-ECN and thus may be unnecessary. Instead, prevention of digestive tract perforation may be more critical for the decrease in post-operative infections. Univariate analyses of PI vs. NPI. | |||||
書誌情報 |
Journal of Clinical Pharmacy and Therapeutics 巻 40, 号 5, p. 573-577, 発行日 2015-10 |
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出版者 | ||||||
出版者 | Wiley-Blackwell | |||||
ISSN | ||||||
収録物識別子タイプ | ISSN | |||||
収録物識別子 | 02694727 | |||||
DOI | ||||||
関連タイプ | isVersionOf | |||||
識別子タイプ | DOI | |||||
関連識別子 | 10.1111/jcpt.12313 | |||||
権利 | ||||||
権利情報 | c 2015 John Wiley & Sons Ltd | |||||
権利 | ||||||
権利情報 | This is the peer reviewed version of the following article: Journal of Clinical Pharmacy and Therapeutics, 40(5), pp.573-577; 2015, which has been published in final form at http://dx.doi.org/10.1111/jcpt.12313 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. | |||||
著者版フラグ | ||||||
出版タイプ | AM | |||||
出版タイプResource | http://purl.org/coar/version/c_ab4af688f83e57aa | |||||
引用 | ||||||
内容記述タイプ | Other | |||||
内容記述 | Journal of Clinical Pharmacy and Therapeutics, 40(5), pp.573-577; 2015 |