Michiteru Fujii

A questionnaire survey on the theory of postoperative infection prophylaxis in gynecology

A questionnaire survey on the theory of postoperative infection prophylaxis was conducted to obtain the consensus on perioperative antimicrobial use among gynecologists in Japan in the period from April to July 2000. Fifty-six of the 83 gynecologists replied, and the following consensus was obtained. An antimicrobial prophylaxis (AMP) agent should be chosen based on their efficacy against the pathogens expected to be contaminants, such as Staphylococcus spp., Escherichia coli and Bacteroides fragilis group. Use an AMP agent that archives a bactericidal concentrations in both the serum and operating site. Use an AMP agent that has little unfavourable side effects. The newer agents should be considered as a therapeutics for postoperative infections. The therapeutic antimicrobial agents having no cross-resistance to the AMP agents should be used, if postoperative infection is suspected or developed. The most commonly used agent for clean operations are cefazolin (CEZ), followed by cefotiam (CTM) and cefmetazole (CMZ). The most commonly used agent for clean-contaminated operations where low grade level of bacterial invasion expected is CTM, followed by CEZ and CMZ, where as operations where mild grade level of bacterial invasion expected is flomxef (FMOX), followed by CTM and other cephalosporins.

Bacteria in Bile and Their Role in Postoperative Inflammatory Complications in Biliary Disease

Some hypotheses have been proposed regarding the mechanisms of development of postoperative infections in cases of gallstone disese or malignant disese of the bile duct. Infections are undoubtedly related to the presence of bacteria in bile collected during surgical procedures.

Thiamphenicol Levels in Human Bile in the Presence of Biliary Tract Diseases

In the present study, the levels of thiamphenicol glycinate in bile and serum were determined in 37 patients following its intravenous administration in a dose of 1g.