在轻度和中度复杂的腹腔内感染中短期和常规抗菌药物持续时间的比较:一项随机对照试验
P Vinodhini1, Sathasivam Sureshkumar1, Balakrishnan Gurushankari1
1Departments of Surgery & Preventive.
Sultan Qaboos University medical journal
|June 28, 2023
概括
短期抗菌疗法 (5天) 与手术后复杂的腹内感染的较长疗程同样有效. 这种方法可以减少治疗时间和住院时间,而不会增加并发症.
科学领域:
- 传染性疾病 传染性疾病
- 手术感染 手术感染
- 抗微生物药物管理委员会
背景情况:
- 复杂的腹内感染 (CIAI) 通常需要手术后进行抗菌疗法.
- 在CIAI的源控制程序 (SCP) 后,抗微生物药物治疗的最佳持续时间仍在争论中.
- 目前正在探索短期抗菌剂方案,以优化治疗并减少耐药性.
研究的目的:
- 为了在CIAI患者中比较短期 (5天) 和常规 (7-10天) 抗微生物治疗持续时间之间的术后并发症率.
- 评估较短的抗微生物治疗持续时间的疗效和安全性.
- 评估对关键临床结果的影响,如手术部位感染和复发性感染.
主要方法:
- 进行了一项单中心,开放标签,随机对照试验.
- 140名患有CIAI的患者随机分为短期 (5天) 或常规 (7-10天) 抗微生物治疗组.
- 主要终点包括手术部位感染 (SSI),复发性腹内感染 (IAI) 和死亡率.
主要成果:
- 在SSI (37%对35.6%),复发性IAI (5.7%对2.8%) 或两组之间的死亡率方面没有发现显著差异.
- 综合初级结局结果相似 (37%对35.7%).
- 在短期疗程组中,抗菌药物治疗的持续时间 (5 vs. 8天; P <0.001) 和住院时间 (5 vs. 7天; P = 0.014) 显著减少.
结论:
- 针对轻度至中度的CIAI,SCP后的五天抗菌疗法在疗效方面与常规疗程相当.
- 短期抗微生物治疗可以安全地减少治疗时间和住院时间.
- 这支持在精选的CIAI病例中使用较短的抗微生物药物疗程.
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