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Several guidelines have recommended that antibiotic prophylaxis (AMP) should be given only at premedication, except in selected cases. Conversely, in clinical practice, AMP is often unnecessarily prolonged after the surgical procedure. In this observational study, we evaluated the risk of surgical site infection (SSI) associated with the prolongation of AMP after clean and clean-contaminated surgery.All consecutive patients who underwent a surgical procedure were eligible. AMP was always administered before the surgical incision. Prolongation of AMP for the first 24 hours was allowed only in presence of at least one risk factor for SSI: an ASA score2 or surgical procedure longer than the specific cutoff (as indicated by the NNIS--the National Nosocomial Infections Surveillance System). SSIs were evaluated during the hospital stay and after hospital discharge.Three hundred fifty-eight patients were enrolled; 19 (5.3%) and 17 (6.5%) patients developed respectively intra-hospital and post hospital discharge SSIs. AMP prolongation for 24 hours in patients with at least one risk factor did not reduce the risk for intra-hospital SSI (OR 1.102; 95% CI: 0.336-3.612; P=0.873), while it increased the risk in patients without risk factors (OR: 8.99; 95% CI: 1.46-55.4; P=0.018). AMP longer than 24 hours raised the risk for intra-hospital and post hospital discharge SSI, regardless of the presence of risk factors (OR: 3.39; 95% CI 1.11-10.35; P=0.032 and OR: 5.39; 95% CI: 1.64-17.75; P=0.006, respectively.)Postoperative AMP prolongation should be avoided.

The present study was designed to show the usefulness of a process analysis based on a joint use of two computerized methods - Mergenthaler's Therapeutic Cycle Model (TCM) and Bucci's Italian Weighted Referential Activity Dictionary (IWRAD). This analysis focused on the transcripts of six sessions from the first eight months of a three-year, face-to-face psychodynamic psychotherapy. Both qualitative and quantita-tive analyses were conducted. Results showed the presence of specific indicators of a good outcome, according to the two approaches, such as the patient's ability to link reflective processes and felt emotions, the occurrence of referential cycles, and the presence of organized and coherent narratives. © 2012 Italian Area Group of the Society for Psychotherapy Research.