Postoperative Infection Rates Clinical Trial
Official title:
Powder Topical Rifampicin on Reducing Infections After Neural Tube Defect Surgery in Infants
The correct timing and technique of neural tube defect (NTD) repairs significantly decreases the morbidity and mortality of NTD cases. However, infections related to the surgery are still common. We investigated the effects of topical rifampicin (RIF) combined with routine prophylaxis in newborns with open NTD.
The study will be conducted in the Yuzuncu Yil University neonatal intensive care unit, Van,
Turkey. The data of 60 neonates diagnosed with open NTD, who will be underwent surgical
intervention between August 2016 and December 2017, will be prospectively evaluated. These
cases will be randomised.These neonates are going to divide into two groups: the
experimental group and the control group. The experimental group will be consisted of 30
newborns diagnosed with open NTDs, administered topical RIF (10 mg/kg/day, 24 h infusion)
and cefotaxime (50 mg/kg/day, two doses, iv), and the control group will be consisted of 30
newborns diagnosed with open NTDs, administered cefotaxime (50 mg/kg/day, two doses).
In this study, researchers will be investigated whether prophylactic topical RIF applied on
a pre-operative mesh in newborns with open NTD reduce the rate of SSIs and meningitis/ VP
shunt infections after surgery. For deep incisional primary SSIs will be evaluated according
to the diagnostic criteria of the United States (U.S.) Centers for Disease Control and
Prevention (CDC) (1). The diagnosis of VP shunt infections will be made after extensive
clinical and laboratory evaluations. the diagnosis of to make shunt infections, criteria of
the Hydrocephalus Clinical Research Network (HCRN) will be taken into consideration (2).
Topical RIF Application Procedure The NTD site will be covered with a sterile gauze dressing
in the first hours of life after birth in all babies with open NTDs. Then, 10 mg/kg/day RIF
will be added to 24 ml of saline (0,9% NaCl), and this will be applied to the mesh as an
infusion at a 1cc/h speed . Every day, the same dose of RIF will be delivered to the
mesh,changed daily, as a 24-hour infusion until the patient could be operated. After the
patient is operated, the RIF infusion delivered to the mesh will be stopped. The cefotaxime
treatment will be continued until 72 hours post-op (3).
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