经外科手术选择的抗生素是否会影响皮肤瘤切除术后感染并发症的发生率? 一个单一盲目的,有前景的随机试验
Henry Collier Wright1, Naveen Kachroo2, Rajat Jain3
1Northwestern Medicine, Huntley, Illinois, USA.
Journal of endourology
|November 2, 2023
概括
齐普罗夫洛克萨和塞法林在皮肤透神经切除术 (PCNL) 期间预防感染方面同样有效. 这项研究发现,在接受PCNL的非高风险患者中,两种抗生素之间的结果,包括全身炎症反应综合征,没有显著差异.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 国家指导方针建议在皮肤透神经切除术 (PCNL) 之前服用抗生素.
- 指南推的抗生素对PCNL的比较疗效尚未得到充分证实.
- 系统性炎症反应综合征 (SIRS) 是PCNL后监测的一个关键结果.
研究的目的:
- 为了比较西普罗夫洛克萨与塞法林在PCNL的外科手术期间抗生素预防中的疗效.
- 评估接受任何一种抗生素的患者中SIRS标准发展的发生率.
- 评估其他术后结果,包括住院时间和重症监护室 (ICU) 的需要.
主要方法:
- 一项随机试验,涉及147名接受PCNL的成年患者,手术前尿液培养结果为阴性.
- 患者被随机分配给接受术前治疗的西普罗夫洛克萨或塞法林.
- 收集的数据包括人口统计信息,SIRS标准,手术内尿液培养和住院时间.
主要成果:
- 在西普罗夫洛克萨和塞法林组之间的手术内或术后发现中没有发现显著差异 (p > 0.05).
- 在塞法林组的住院时间略长 (2小时,p = 0.02).
- 在单变体和多变体分析中,两组抗生素之间SIRS发作的发生率没有统计学上显著的差异.
结论:
- 在非高风险PCNL患者的外科手术期间抗生素预防中,西普罗夫洛克萨没有显示其优于塞法林.
- 齐普罗夫洛克萨和塞法索林都是PCNL预防的合适抗生素选择.
- 进一步的研究可能会探索基于局部耐药性模式的抗生素选择.
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