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At the First Orthopaedic Clinic in Bratislava during the last two years 748 children were hospitalized. Of these 405 had surgical operations: 260 operations of bones, 61 operations of joints and 84 operations of soft parts. Patiens with osteomyelitis and pyarthrosis were hospitalized in 0,5 %, with reactive arthritis in 0,6 % (not associated with the surgical operation made in the authors' department). For prophylactic and therapeutic administration of antibiotics Ampicillin was administered in 266%, Oxacillin in 15,8 %, Cephalosporins in 12,8 %. Prophylactic administration of antibiotics, incl. the first dose before surgery, accounted for 626%. After this antibiotic prophylaxis the inci dence of secondary chronic osteomyelitis was 0,24 %. Surface infections of the wound were re corded in 3,4 % and deep infections in 1,2 %. Non-orthopaedic infections (mainly upper respira tory pathway infections) during the postoperative period occurred in 7,1 %, they varied, however, de pending on the epidemiological situation. Based on their own observations and data in the literature the authors recommend antibiotic prophylaxis in children for 24-48 hours in the following order: Cephalosporins, Oxacillin, Ampicillin. When changing from prophylactic to therapeutic antibiotic administration it is necessary to take into account the clinical picture and state of the wound. Febrility, red cell sedimentation rate, Le do not always correlate with the infection of the wound. In children during the postoperative period also frequent non-orthopaedic infections must be taken into account. Key words: osteoarticular infection, incidence, antibiotic prophylaxis. |
