[Villages PL]

In yesterdays Daily sun (Jan. 1, 2015, page A4) there was a Q&A with the president and CEO of the Central Florida Health Alliance.

Q: What's the top accomplishment for 2014?

A: "We have been working for several years behind the scenes to decrease our hospital-acquired infections and improve our patient-safety ratings. And all of those began to be recognized by the outside national companies that look at these things and rank hospitals."

My comment: Having just read the book, "Missing Microbes", by Martin J. Blaser, MD, I learned that hospitals give people antibiotics before open heart surgery to prevent infection.

Is this how hospitals are dealing with the problem? What about other operations, do they get routine antibiotics too? Is this the reason why some hospitals are doing better? Is this the right way to go about preventing infections? I thought they had new special equipment to automatically disinfect rooms etc..

Lack of information leads to speculation: The newspaper is often full of statistics but there were none concerning the rate of infections. What percentage of patients had hospital-acquired infections in previous years compared to those in 2014? If there was truly significant improvement, why not let us in on the details and tell us how it was accomplished.

[blueash]

If you use google scholar as your search engine you can search for medical studies using whatever parameters you choose You may then look at the hits. Some will only be links to a brief summary as the whole article will be hidden behind a paywall. Other times you can read the whole study. You will find the answer to the risk vs benefit of prophylactic antibiotics in those studies much more likely than on this forum.

For articles on use in heart surgery since 2011 you will get results such as this
prophylactic antibiotics heart surgery - Google Scholar

[dbussone]

As blue ash points out almost all operations, and many other procedures,involve the use of prophylactic antibiotics. They are usually administered within 60 minutes prior to the start of a procedure. The purpose is to reduce the opportunity for an infection to develop.

[Villages PL]

Originally Posted by blueash

If you use google scholar as your search engine you can search for medical studies using whatever parameters you choose You may then look at the hits. Some will only be links to a brief summary as the whole article will be hidden behind a paywall. Other times you can read the whole study. You will find the answer to the risk vs benefit of prophylactic antibiotics in those studies much more likely than on this forum.

For articles on use in heart surgery since 2011 you will get results such as this
prophylactic antibiotics heart surgery - Google Scholar

Thanks for the information.

JAMA Network | JAMA Surgery | Timing of Surgical Antibiotic Prophylaxis and the Risk of Surgical Site Infection

The following statement, from the above link, got my attention:

"Numerous studies have failed to demonstrate that adherence to the Surgical Care Improvement Project prophylactic antibiotic timely administration measure is associated with decreased surgical site infection (SSI)."

Therefore it seems if The Villages hospital is making progress with this problem it's not because of prophylactic antibiotics. We still don't know the extent of the problem, like what is their infection rate and how does it compare with previous years. Or: How many people die each year from infections? There's no substitute for them being straight-forward with the public.

[rubicon]

Too many assumptions being rendered here

[Bogie Shooter]

And accusations....................

[dbussone]

Per usual

[sunnyatlast]

If you want to go back to the days before penicillin, head for the hills, build an off-grid hut, and don't go to a doctor or dentist.

Here is an excerpt from a memoir of those "wonderful" pre-penicillin days:

The discovery of penicillin has often been described as a miracle drug, and that is exactly what it was. Prior to the discovery of penicillin, death could occur in what would seem, today, to be very trivial injuries and diseases. It could occur from minor wounds that became infected or from diseases such as Strep Throat, and venereal diseases such as syphilis and gonorrhea were a much more serious issue.

Early in 2005, an email came asking for information about penicillin. The email was from Dr. Morton Paterson, a retired philosophy professor, now living in Canada. He was writing his autobiography for his grandchildren as a legacy for them. Part of that autobiography had to do with the impact penicillin played in his life. When he emailed me the story, I knew that it was one that I wanted to share. As a boy, just prior to the discovery of mass producing penicillin, Dr. Paterson had badly scraped his knee, an injury that he almost died from. The following is his account of this injury and how it was treated at that time:

"It was the late spring of 1942, and I was seven years old. My sister Lorna had just been born. One day I was outside playing with my friends - running while playing tag or something. There weren't any parks or grassy fields, so the kids played on the rocks or on the streets. I fell on the street, which was covered with chunks of slag (waste from the Smelter), and scraped my right knee. I guess it was bleeding pretty bad, so I ran home. Later I was told that it was on a Wednesday, and that my temperature shot up and up. By Saturday Mum and Dad had a sick boy on their hands, so on the advice of Dr. Chappell, our family doctor, I was rushed to St. Joseph's Hospital in Sudbury.

The cut on my knee had become infected, and I had blood poison. For a few days I guess I was "out of it", in a coma, and hung in the balance between life and death. I was diagnosed as having osteomyelitis, which means "bone infection". Apparently what happens with osteomyelitis is that the infected blood seeks out a part of the body which is already weak for some reason. In my case that happened to be the socket in my left hip.
Don't ask me why I had a weak hip - cause I don't know the answer. I just did.

Anyway, they knew they had to operate fast to stop the infection before it traveled to a vital organ. That led to three months in hospital. The surgeon was Dr. Mowat, and I remember him as a very kind and soft-spoken man. He had to scrape out the infected bone, but then leave the large incision open so the nurses could pack it every day with fresh gauze……."

Penicillin, The Wonder Drug


….

[Villages PL]

Originally Posted by Villages PL

Thanks for the information.

JAMA Network | JAMA Surgery | Timing of Surgical Antibiotic Prophylaxis and the Risk of Surgical Site Infection

The following statement, from the above link, got my attention:

"Numerous studies have failed to demonstrate that adherence to the Surgical Care Improvement Project prophylactic antibiotic timely administration measure is associated with decreased surgical site infection (SSI)."

Therefore it seems if The Villages hospital is making progress with this problem it's not because of prophylactic antibiotics. We still don't know the extent of the problem, like what is their infection rate and how does it compare with previous years. Or: How many people die each year from infections? There's no substitute for them being straight-forward with the public.

If numerous studies have failed to demonstrate any positive outcome for the use of prophylactic antibiotics in a hospital setting, then I doubt The Villages Hospital has anything other than that same result. If they do have a positive result, then they should shout it from the rooftops and let other hospitals learn from their experience. At the same time we Villagers would be proud of their accomplishment. Let's here about it!

As far as how many people die each year from hospital infections, I'm not assuming anything. It might be zero. Wikipedia: Zero is a number. So again I ask, "How many people die each year from infections?"

If prophylactic antibiotics have no positive outcome, should patients be needlessly exposed to them?

[Barefoot]

Originally Posted by sunnyatlast

If you want to go back to the days before penicillin, head for the hills, build an off-grid hut, and don't go to a doctor or dentist.

You nailed it Sunny.
As a preventative measure, because of a knee replacement, for two years I'm required to take an anti-biotic before I have my teeth cleaned.
I don't worry about it.
I think that needless worrying about statistics is just another way to shorten a healthy lifespan.

[Villages PL]

Originally Posted by Barefoot

You nailed it Sunny.
As a preventative measure, because of a knee replacement, for two years I'm required to take an anti-biotic before I have my teeth cleaned.
I don't worry about it.
I think that needless worrying about statistics is just another way to shorten a healthy lifespan.

Nothing was nailed unless you mean the subject was shifted to something else. My questions are still valid questions that haven't been answered.

[dbussone]

If I recall correctly, I gave the OP a link several months ago that provided access to the most recent CDC report on hospital related deaths and hospital acquired infections. It was about 97 pages long.

[champion6]

Originally Posted by Villages PL

Lack of information leads to speculation: The newspaper is often full of statistics but there were none concerning the rate of infections. What percentage of patients had hospital-acquired infections in previous years compared to those in 2014? If there was truly significant improvement, why not let us in on the details and tell us how it was accomplished.

No one on TOTV is able to supply the detailed information you desire. Therefore, your speculation will continue. Why don't you call The Villages Regional Hospital and ask for their Director of Infection Control? This person is responsible for these issues which intrigue you.

[dbussone]

Excellent suggestion!

[graciegirl]

Why is the use of prophylactic antibiotics before surgery of interest to you?

Do you think from reading your book that you have sufficient information to call for the abandonment of prophylactic antibiotics before surgery?

What is the point of your inquiry?

Has it been suggested that you have surgery?

Do you dislike the use of antibiotics because you feel the use of any medicine is in conflict with your views on healthy diet?

What is the point of your interest and concern and how is it tied to your healthy diet and your abhorrence of obesity?