青素过敏标签是否会影响复杂的牙感染的结果?
Sagar Chadha1, Jonathan P Troost2, Paul L Shivers3
1Resident, Department of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI.
概括
被标记为青素过敏的患者面临更高的抗生素耐药性,特别是克林达米辛,尽管治疗结果相似. 重新评估青素过敏状态对于在牙感染中有效选择抗生素至关重要.
科学领域:
- 口腔和牙面部外科手术
- 传染性疾病 传染性疾病
- 临床药房 临床药房
背景情况:
- 青素是治疗牙感染的主要抗生素,但据报道的过敏症限制了它们的使用.
- 这导致医疗保健成本增加,并导致替代抗生素引起的并发症.
- 相当一部分人口被标记为青素过敏,影响治疗策略.
研究的目的:
- 评估青素过敏标签与复杂牙感染治疗结果之间的关联.
- 为了研究患有或没有青素过敏标签的患者的抗生素耐药性模式.
- 为了告知临床实践关于抗生素选择的odontogenic感染.
主要方法:
- 一个回顾性队列研究,对150名患者进行复杂的牙感染治疗 (2016-2020年).
- 主要预测因素:青素过敏标签 (图表评论). 主要结局:住院时间. 二次结局:入院ICU,重复CT,重复手术,重新入院.
- 二级目标:与青素过敏标签相关的抗生素耐药性 (伤口培养). 进行了回归分析.
主要成果:
- 被标记为青素过敏的患者 (17.3%) 与非过敏患者相比,表现出类似的治疗结果.
- 青素过敏与较高抗生素耐药性风险显著相关 (RR=2.34).
- 具体来说,在青素过敏患者中,克林达米辛耐药性显著更高 (RR=3.17).
结论:
- 青素过敏标签与牙致病感染中克林达米辛耐药性增加有关.
- 无论青素过敏状况如何,治疗结果都是可比的,这表明"脱标"的可能性.
- 考虑"取消标签"的举措,并利用当地的抗生素耐药性数据进行知情的处方.
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