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Keimyung Medical Journal 1990;9(1):113-122.
Use of Prophylactic Antibiotics in Surgery
외과환자에 있어서의 예방적 항생제의 사용
김유사; 김종국
Abstract
To evaluate the use or abuse of prophylactic antibiotics in surgery; a total of 300 patients were randomly selected from the patients admitted to the department of surgery; Keimyung University Dongsan Medical Center from 1982 to 1988. Patients who received inguinal herniorraphy; thyroid surgery; modified radical mastectomy; appendectomy; biliary surgery; and gastric surgery were included in this study and ten patients were randomly selected for each year group for each surgical category and antibiotic use was analysed. In clean surgical procedures including inguinal herniorrhaphy; thyroid surgery; and breast surgery; the use of prophylactic antibiotics has improved over the years and by 1988 there was no unnecessary use of antibiotics in these procedures except in breast operations where the antibiotic use was stilt found in 30나 of cases in 1988. In appendectomies; the use of antibiotics can be both prophylactic and therapeutic but in simple acute appendicitis without gangrenous changes or perforations; the use can be limited to a preoperative single dose with same effectiveness. The antibiotic use in this hospital in cases of simple acute appendicitis was appropriate for the timing of the first dose but the duration of the use was prolonged to an average of 5 days. In biliary and gastric operations the use of antibiotics was appropriate for the timing of the first dose but again the duration of the use was prolonged. The indications (or the use of prophylactic antibiotics; the timing of the first dose; the duration of the antibiotic use; and the selection of proper antibiotics for specific operations are discussed.


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