Volume 5, Issue 4, 1997
Review
Antimicrobial prophylaxis in clean surgery
de Lalla Fausto
Antibiotic prophylaxis in clean surgery is generally not required except for prosthetic cardiac, vascular and orthopedic surgery. In these cases, the cephalosporins mostly active against staphylococci such as cefazolin, cefuroxime and cefamandole or antistaphylococcal penicillins, such as oxacillin, associated or not with aminoglycosides, are recommended. The progressive increase of methicillin-resistant staphylococci has led to use for the above mentioned surgeries also glycopeptides, especially in those wards where methicillin resistance is particularly high. Nevertheless, not enough many prospective-controlled studies have been carried on to evaluate whether glycopeptides reduce the risk of post-surgical infections, more than other conventional antibiotic regimens. Furtherly, the possible risk of selecting glycopeptide-resistant enterococci suggests that prophylactic use of glycopeptides should be limited and a minimal number of doses should be administered, favouring whenever possible, the ultra short term prophylaxis (single dose).
Malaria: state of art
Morelli Giuseppe,
Amoroso Pietro
Some actual aspects of malaria are here described. After an outline of the actual epidemiological situation of malaria endemic in the world and some historical reports on Italian malaria phenomena before the istitution of malaria control measures, chemoprophylaxis and its more problematic aspects, mainly related to multiresistant drug Plasmodium falciparum strains, are discussed in the first part.
In the second part the factors potentially implicated in a reintroduction of malaria in free areas are analyzed; with a special reference to climatic changes. Finally the more recent vaccine perspectives are summarized; the Authors discuss the principal exeperiences made using synthetic peptides of different plasmodial origin.
Original article
Acute rheumatic fever: a report
Boccazzi Antonio,
Bellosta Clara,
Tonelli Piera
Acute rheumatic fever (ARF) is still an important disease of the pediatric and adult age. The increased number of cases described in the literature in the last 10 years brought us to evaluate the ARF cases diagnosed in a Pediatric Teaching Hospital in the period 1988-1997. Most of the children with ARF presented with joint involvement even if patients with cardiac disease or corea minor were numerous. About 50% of our patients with ARF did not refer a history of a febrile tonsillopharyngitis in the 15-60 days before the presentation of ARF. The remaining patients have had a preceding pharyngitis not adequately treated. In none of the subjects a throat swab positive for group A beta hemolytic streptococci was available. These results confirm the importance of the correct diagnosis and treatment of streptococcal pharyngitis but suggest that ARF can develop without any outstanding clinical evidence of streptococcal infection.
“In vitro” sensitivity of bacterial strains isolated from urine cultures in the period 1995/96
Camporese Alessandro,
Tizianel Gianni
Urinary tract infections represents a very frequent pathology. An epidemiologic survey on 6632 urine samples has been performed in the years 1995/96 to verify the bacterial incidence and susceptibility to antimicrobial drugs in this period, and variations in the resistance patterns with respect to a previous study. The results suggest the importance of a constant epidemiological surveillance in the community setting
Pharmacoeconomics aspects of antibiotic therapy for AIDS patients in department of infectious disease
Sabbatani Sergio,
Martelli Luisa,
Castelvetri Cristina,
Di Crescenzo Ettore
The financial budget for public health care in Italy has been more and more restricted in the last few years, but, on the other hand, the care of AIDS patients is still very expencive and antibiotic therapy plays an important role in the management and cost of these patients. The antibiotic therapies and related costs have been evaluated in 99 patients affected by AIDS (59 pts), ARC (28 pts) or HIV serum positive (12 pts), all hospitalized or treated in Day Hospital for different bacterial infections in 1995 at the Department of Infectious Diseases, Ospedale Maggiore, Bologna, for a total of 7733 days of antibiotic therapy. The average cost for antibiotic therapy was about 400.000 Italian Lira, with no significant difference depending on the stage of HIV related disease. The crude cost for antibiotic treatment was not particularly high, but the high frequency of adverse events, registered in these patients, required additional medical support and/or a prolonged hospital stay, which increased substancially the total cost of managment of bacterial infections.
Case report
Hepatitis-like syndrome induced by nimesulide?
Carniato Antonella,
Vaglia Alberto
The Authors describe a case report of a 17 years old woman, complaining of weakness and malaise, associated with a significant increase of serum transaminases, that occurred twice in a month soon after the administration of Nimesulide per os.
Ultrasonography in diagnostic and therapeutic management of the abscesses due to Actinomyces spp.
Giorgio Antonio,
de Stefano Giorgio,
Tarantino Luciano,
Perrotta Anna,
Aloisio Vincenza,
Forte Giacinto
A case of abscess of massetere muscle by Actinomyces spp. is described. Ultrasound-guided fine needle aspiration allowed diagnosis by citology. Specific antibiotic treatment was started and US-follow-up showed complete healing of the lesion with restitutio ad integrum of the muscle.
