Besides emphasizing the importance of existing guidelines (antiseptic shower, hair removal by clipper, strict hand hygiene, prophylactic antibiotics, limiting OR traffic, tight glycemic control (80 to 110 mg/ dl), and so on), new strategies were introduced.
This includes more training of staff in order to avoid anaesthetic and surgical complications, strict use of prophylactic antibiotics to decrease the number of postoperative infection, as well as earlier detection and more effective treatment of postpartum haemorrhage after CS.
This is thought to be a result of improved perinatal medical practice, such as strict aseptic technique, and prophylactic use of antibiotics reducing the frequency of infection.
In contrast, the French guidelines do not recommend self-examination (because this may induce fear) and are very strict with regard to prophylactic mastectomy (Eisinger et al, 1999).
If it were possible to predict the development of bone marrow suppression before the white blood cell (WBC) count had actually decreased, treatment could be improved by strict dosage control and/or the prophylactic administration of hematopoietic drugs.
Thus, a biomarker that is able to detect the early onset of a side effect, such as bone marrow suppression before a detectable decrease in WBC count, would allow the patient to receive more appropriate treatment (e.g., strict anticancer dosage control and/or prophylactic administration of hematopoietic drugs).
Interpretation The inadequate timing of prophylactic antibiotics indicates that the standards of strict antiseptic and aseptic routines in arthroplasty surgery are falling.
If we use appropriate precautionary measures such as the strict control of the treatment protocol of TS-1 and/or the prophylactic administration of hematopoietic reagents (e.g. G-CSF), the discontinuation of TS-1 therapy may be avoided or at least delayed.
Systems designed for prolonged release of prophylactic inhibitory or subinhibitory amounts of antibiotics, in absence of strict harmonized guidelines, raise concerns for their still weakly proved efficacy but, even more, for their possible contribution to enhancing biofilm formation and selecting resistant mutants.
This sample composition might be due to our strict criteria of euthymia and time elapsed since remission, or due to effective prophylactic treatment (Pfennig et al. 2014).
