潜在的随机试验的抗生素预防的持续时间,在低风险的患者皮肤内切除术
Luke Griffiths1, Tareq Aro1, Patrick Samson1,2
1Smith Institute for Urology, Northwell Health, New Hyde Park, New York, USA.
Journal of endourology
|August 14, 2023
概括
对于接受皮肤穿神经切除术 (PCNL) 的患者来说,24小时的抗生素预防方案与更长的时间一样安全和有效. 这项研究发现,在低风险患者中,较短的抗生素疗程没有增加感染风险.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染病管理 传染病管理
- 预防手术并发症 预防手术并发症
背景情况:
- 手术后感染和败血症是皮肤透神经切除术 (PCNL) 的常见并发症.
- 目前的指导方针建议对PCNL进行短期 (≤24小时) 抗生素预防,但实践不同.
- 优化抗生素持续时间对于平衡感染预防和抗菌药物管理至关重要.
研究的目的:
- 在低风险的PCNL患者中,比较24小时抗生素预防方案的疗效和安全性与更长时间的疗程方案,直到外部导管切除.
- 评估与感染相关的结果,包括发烧发作,全身炎症反应综合征,细菌病和尿路感染.
主要方法:
- 一项前性随机研究,涉及98名低风险患者,接受PCNL的无菌手术前尿液培养.
- 患者被随机分配,在手术后最多24小时 (24小时组) 或直到外部尿管导管切除 (CR组) 之前接受抗生素.
- 使用了标准的抗生素治疗方案,但排除了先前接触过抗生素,尿液过敏史或免疫抑制的患者.
主要成果:
- 平均抗生素持续时间为20.6小时 (24Hr组) 和34.0小时 (CR组) (p=0.04).
- 两组之间在发烧发作,全身炎症反应综合征,细菌病或培养证明的尿路感染方面没有发现显著差异.
- 整体并发症率相似,包括在不包括"无管"程序的子组分析中.
结论:
- 在低风险的PCNL患者中,24小时的抗生素预防方案与持续使用抗生素,直到外部导管切除为不劣.
- 较短的抗生素持续时间不会增加这种患者群体感染相关并发症的风险.
- 这些发现支持遵守PCNL推的24小时抗生素持续时间,以优化抗菌管理.
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