Dietmar Frey Boeken

Thoracic (lung) surgery is particularly charged with complications of infection. Antibiotic prophylaxis (APr) is commonly performed; significant beneficial effects are still unproven. In a randomized controlled trial, a single-shot APr with 1.5 gr cefuroxime was performed in a total of 200 patients (control/test group; both 100 pat.). Post-operative wound / pleural / urinary tract infections and clinical signs of infection / pneumonia were less frequent in the APr group. Bacteriological examinations prove a relevant reduction of tracheo-bronchial existing germs as well as the prevention of intubation-related new colonization. Consecutively, antibiotic therapy is less frequent after APr, with lower costs overall. Substantial and multiple significantly more favorable results after APr are found for the sign infiltrate in chest radiographs. The frequency and severity of infiltrates often correlate significantly with leukocyte counts and gas exchange measurements. Thus, the infiltrate often characterizes inflammatory lung changes. Defined risks (malignancy, age, smoking, obesity, obstruction, positive germ detection tracheo-bronchial) show multiple (highly) significant correlations to the sign infiltrate in elaborate statistical analyses. It has been shown that especially non-risk patients benefit from APr; the non-prophylaxis (control group) proves statistically to be an independent pneumonia risk. CONCLUSION: A single-shot APr establishes clinical advantages for thoracic surgical procedures. Furthermore and more significantly it is proven that antibiotic colonization / infection prophylaxis is possible for internal tracheal and pulmonary surfaces . The findings should be noteworthy with regard to obligatory pharyngo-tracheal germ carriage during standard intubation. Jetzt reinlesen: Inhaltsverzeichnis(pdf)