预防性抗生素用于骨科瘤学中的大规模内置假体
Tariq Azamgarhi1, Simon Warren2, Sarah Fouch3
1Pharmacy Department, Royal National Orthopaedic Hospital NHS Trust, London, UK.
The bone & joint journal
|July 31, 2023
概括
在骨瘤手术后的24小时内延长抗生素预防没有显示任何益处. 在瘤手术中预防性抗生素治疗方案 (PARITY) 试验提供了关于在骨科瘤学中最佳抗生素使用的关键见解.
科学领域:
- 整形瘤学 整形瘤学
- 传染病管理 传染病管理
背景情况:
- 抗生素预防对于骨瘤的内成形重建是标准的.
- 目前的指导方针经常建议扩展预防,但证据有限.
- 对抗生素耐药性和C. difficile感染的担忧需要基于证据的指导方针.
研究的目的:
- 审查在骨科瘤学中选择抗生素,剂量和时间的证据.
- 讨论PARITY试验对临床实践的影响.
- 确定骨瘤手术抗生素预防的剩余知识缺口.
主要方法:
- 审查关于抗生素预防的现有文献.
- 在瘤手术 (PARITY) 试验中预防性抗生素治疗方案的分析.
- 讨论临床影响和未来的研究方向.
主要成果:
- 在PARITY试验中,在下肢骨瘤手术中,将抗生素预防的时间从24小时延长到5天没有任何好处.
- 对于特定的抗生素选择的证据,特别是在避免使用头类的地区,仍然存在很大的差距.
- 该试验代表了骨科瘤学中具有里程碑意义的随机对照试验.
结论:
- 目前的证据不支持延长抗生素预防治疗超过24小时后,为骨瘤进行内膜修复.
- 需要进一步的研究来优化抗生素的选择,剂量和时间,考虑到区域差异和C. difficile风险.
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