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Analysis of the possibilities of influencing antibiotic prophylaxis on the basis of inflammatory markers II
Strnadová, Gabriela ; Malý, Josef (advisor) ; Šorf, Aleš (referee)
Analysis of the possibilities of influencing antibiotic prophylaxis on the basis of inflammatory markers II Author: Gabriela Strnadová Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Petr Domecký Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Periprosthetic joint infections are considered as the biggest complication of the implementation of the total arthroplasty which may be reduced by the observation of inflammatory and nutritional markers. The aim of this thesis is to analyse the possibilities of influencing the antibiotic prophylaxis (AP) on the basis of those markers observed on patients that underwent the total hip arthroplasty (THA) and the total knee arthroplasty (TKA). Methods: Data was collected from a prospective study which began in March 2020 at the Department of Orthopedics at the University Hospital Hradec Králové. There were 118 patients from May 2021 to June 2022 older than 18 years with THA and TKA included in the analysis. The analysed data were sourced from the paper and electronic forms of medical documentary materials of those patients. Patients'personal and medical details (including the information about the operation, the thromboprophylaxis (TP), AP, and the results of physical and...
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Influence of early antibiotic treatment on lower airway microbial colonisation in patients receiving mechanical ventilation
Kroupová, Alžběta ; Duška, František (advisor) ; Kukol, Václav (referee)
AJ Introduction: Ventilator-associated pneumonia (VAP) is a significant source of morbidity and mortality among patients undergoing mechanical ventilation. Its development is preceded by colonization of the lower respiratory tract with pathogenic bacteria. The purpose of this study was to investigate how antibiotic therapy administered for non-pulmonary infections affects the colonization of the lower respiratory tract compared to patients not receiving antibiotics. The hypothesis is that antibiotic treatment reduces colonization of the lower respiratory tract but increases the occurrence of multidrug-resistant bacteria. Methods: This was a retrospective observational cohort study conducted on critically ill patients hospitalized at the Department of Anesthesiology and Resuscitation, Third Faculty of Medicine, Charles University, and University Hospital Kralovske Vinohrady. This study is part of an ongoing project aimed at improving the quality of care and preventing VAP in intensive care unit patients. Patients had to meet certain criteria: they had to be on mechanical ventilation for more than 48 hours, have no pre-existing pulmonary diseases upon hospital admission, and not be immunocompromised. The primary outcome was the difference in the proportion of patients with positive microbiological...
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Analysis of the possibilities of influencing antibiotic prophylaxis in orthopedics on the basis of inflammatory markers
Preiss, Přemysl ; Malý, Josef (advisor) ; Doseděl, Martin (referee)
Analysis of the possibilities of influencing antibiotic prophylaxis in orthopedics on the basis of inflammatory markers Author: Přemysl Preiss Tutor: doc. PharmDr. Josef Malý, Ph.D. Consultant: PharmDr. Petr Domecký Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aim: Endoprosthetic surgeries are demanding orthopedic surgeries rarely associated with complications, that can be fatal. One is periprosthetic joint infection (PJI), whose risk can be decreased by antibiotic prophylaxis (AP). The aim of this effort was to describe trends in endoprosthetic surgeries of the knee and the hip, their complications and options of diagnostics in the theoretical part. The aim of the practical part was to analyze prognostic features of chosen laboratory parameters on postoperative infections, respectively on postoperative complications. Methods: This prospective study started in March 2020 and data gathering took place until 28. 3. 2022 at the Ortopedic Clinic of the University Hospital Hradec Králové. Patients, who were included in the study, fulfilled the preliminary criteria, e.g. age ≥ 18 years, patient undergoing total hip or knee arthroplasty at the time of the study and giving the informed consent to the study. Data were gathered from...
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Antibiotic prophylaxis of extensive obstetric perineal injuries repair
Menzlová, Erika ; Záhumenský, Jozef (advisor) ; Procházka, Martin (referee) ; Roztočil, Aleš (referee)
Objective Our aim was to compare two regimens of antibiotic prophylaxis at the time of repair of obstetric anal sphincter injury. Benefit of long regimen of antibiotic prophylaxis in comparison with short regimen of antibiotic administration haven't been till now proven. Material and Methods Women who gave vaginal birth in department of gynaecology and obstetrics of the First Faculty of Medicine of Charles University and Hospital Bulovka from 1.1.2008 to 30.6.2013 and who sustained third - or fourth - degree perineal tears have been enrolled in our trial. All women who fulfilled trial criteria received at the time of repair antibiotic prophylaxis which was cefuroxim (second - generation cephalosporin). This antibiotic has good sensitivity to vaginal gram-positive flora and to rectal gram-negative microorganisms too. Suture technique and following postpartum care have been standardized. All enrolled women were checked 2 weeks and 3 months after delivery. We evaluated subjective and objective parameters of healing of the obstetric perineal injury and 3 months postpartum we looked for symptomps regarding anal incontinence. The Manchester questionnaire was used for evaluation of anal incontince occurance. Results Incidence of third - and fourth - degree perineal tears was 1,4 % during period of our...
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Antibiotic prophylaxis of extensive obstetric perineal injuries repair
Menzlová, Erika ; Záhumenský, Jozef (advisor) ; Procházka, Martin (referee) ; Roztočil, Aleš (referee)
Objective Our aim was to compare two regimens of antibiotic prophylaxis at the time of repair of obstetric anal sphincter injury. Benefit of long regimen of antibiotic prophylaxis in comparison with short regimen of antibiotic administration haven't been till now proven. Material and Methods Women who gave vaginal birth in department of gynaecology and obstetrics of the First Faculty of Medicine of Charles University and Hospital Bulovka from 1.1.2008 to 30.6.2013 and who sustained third - or fourth - degree perineal tears have been enrolled in our trial. All women who fulfilled trial criteria received at the time of repair antibiotic prophylaxis which was cefuroxim (second - generation cephalosporin). This antibiotic has good sensitivity to vaginal gram-positive flora and to rectal gram-negative microorganisms too. Suture technique and following postpartum care have been standardized. All enrolled women were checked 2 weeks and 3 months after delivery. We evaluated subjective and objective parameters of healing of the obstetric perineal injury and 3 months postpartum we looked for symptomps regarding anal incontinence. The Manchester questionnaire was used for evaluation of anal incontince occurance. Results Incidence of third - and fourth - degree perineal tears was 1,4 % during period of our...
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INFECTION AS A RISK FACTOR DURING PREGNANCY
HRUBEŠOVÁ, Martina
The thesis Infection as a risk factor during pregnancy is divided into two parts {--} theoretical and practical {--} and has a character of a research study. The theoretical part deals with aspects of infections during pregnancy. The main attention is paid to the questions of pregnant women colonized with group B Streptococci (GBS, Streptococcus agalactiae) which may cause a large scale of infectious diseases in newborns, including the life threatening sepsis. This part of the thesis is divided into seven chapters. They provide brief information on the etiological agent, risk factors, clinical picture of the disease, current possibilities of the disease diagnostics. The present day system of the optimal procedure of screening to identify women colonized with GBS and the procedure of the intrapartal antibiotic prophylaxis are also mentioned in the theoretical part. The objective of the practical part is to find the percentage of newborn infants delivered by mothers colonized with GBS who are also colonized with GBS despite their mothers having been treated by the intrapart antibiotic prophylaxis. The hypothesis I assumes that the intrapart antibiotic prophylaxis was administered to women colonized with GBS more than 4 hours before delivery. The hypothesis II presumes that newborns of GBS positive mothers who had been administered the antibiotic prophylaxis at least 4 hours before delivery were not colonized with GBS. The quantitative research was used to verify or reject the hypotheses. It was carried out by the retrospective analysis of medical records of women who gave birth between 1 June 2006 and 8 August 2007 at the maternity hospital in České Budejovice and had been colonized with GBS. The purpose of this thesis is to evaluate the antibiotic prophylaxis carried out in the maternity hospital in České Budejovice and to introduce the conclusions into practice and training.
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