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AbstractBackground:We created a questionnaire with the aim of evaluating surgeon compliance with the guidelines for antibiotic use in the perioperative period in intra-abdominal surgical infections. We discuss the problems emerging from non-adherence to these guidelines.Methods:In the questionnaire, we tried to correlate the type of intra-abdominal infection with: (1) Time of antibiotic administration commencement; (2) type of antibiotic(s) administered; (c) duration of antibiotic administration; and (4) modification of antibiotic type/duration of administration in the presence of factors increasing the risk of treatment failure. In order to collect and process the data more easily, the patients were divided into four groups–Group A: Community patients with intra-abdominal surgical infections and simple contamination of the peritoneal cavity according to the Surgical Infection Society (SIS) guidelines; Group B: Community patients with an intra-abdominal surgical infection evolving to secondary peritonitis per SIS guidelines; Group C: Community patients with an intra-abdominal surgical infection with a high risk of surgical site infection; and Group D: Patients with recent hospitalization or nosocomial or postoperative intra-abdominal infection.Results:The questionnaire was sent to the directors of 43 surgical clinics in northern Greece, and 27 answered (63%). In 81.5% of the clinics (median 22; range 15–24), depending on the type of infection, empirical antibiotic treatment commenced preoperatively. In Group A, on average, 29.6% of the clinics (median 8; range 5–16) administer antibiotics for as long as 24 h, and 11.1% (median 3; range 1–10) use antibiotics not recommended in the SIS guidelines (e.g., third- and fourth-generation cephalosporins, ciprofloxacin, imipenem-cilastatin, meropenem, or piperacillin/tazobactam). In Group B, 22.2% of clinics (median 6; range 2–15) administer antibiotics for three to five days, and 14.8% (median 4; range 1–11) use antibiotics outside SIS guidelines. In Group C, 40.7% of clinics (median 11; range 1–14) administer antibiotics for more than five days, and 14.8% (median 4; range 1–14) use antibiotics that are outside the SIS guidelines. In Group D, 11.1% of clinics (median 3; range 2–5) do not cover Enterococcuswith the antibiotics administered.Conclusions:There seems to be confusion in determining the situations with simple contamination of the peritoneal cavity, whose treatment requires short-duration antibiotic administration, and in the type of antibiotics administered to various patient groups, elements that lead to prolonged or erroneous administration of antibiotic drugs. Continuous discussion and surgeon training is imperative and may be the best choice to ensure familiarity with antibiotics and their proper use and thus to minimize serious adverse events and treatment failure. [ABSTRACT FROM AUTHOR]

AbstractBackground:We present a case of a hydatid cyst located in the left thigh.Case Report:A 67-year-old man was admitted to our department with a 10 × 5 × 4 cm mass in the medial compartment of the left thigh. Computed tomography scan indicated possible hydatidosis. Serological testing (indirect hemagglutination) was positive for hydatidosis. The patient was operated seven years ago for liver hydatidosis.Results:The patient, after evaluation, underwent surgical excision of the cyst under epidural anesthesia. The cyst was located in the left quadriceps muscle; had a soft, elastic substance; was firmly attached to the muscle fibers; and contained transparent fluid and daughter cysts. Histologic examination confirmed the initial diagnosis. The patient was discharged on the fifth postoperative day.Conclusions:The diagnosis of muscular hydatidosis is difficult and the usual diagnostic methods are the serological tests for hydatidosis and imaging (e.g., ultrasound, computed tomography, and magnetic resonance imaging). In every soft tissue mass with benign characteristics the existence of a hydatid cyst should always be considered. Careful surgical excision of the intact cyst is the treatment of choice, but complementary control for liver—or other organ—hydatidosis should be performed. [ABSTRACT FROM AUTHOR]