在深胸部伤口感染的重建性手术中使用抗生素治疗
P Unbehaun1, L Prantl2, S Langer3
1Department of Plastic, Hand and Reconstructive Surgery, Universitätsklinikum Regensburg, Regensburg, Germany.
Clinical hemorheology and microcirculation
|November 26, 2023
概括
长期使用抗生素治疗深胸部伤口感染 (DSWI) 超过14天没有任何好处,并增加多药性耐药性. 仅仅进行手术治疗对没有感染迹象的DSWI是有效的,用linezolid适用于阳性病原体.
科学领域:
- 传染性疾病 传染性疾病
- 手术感染 手术感染
- 抗生素耐药性 抗生素耐药性
背景情况:
- 深胸部伤口感染 (DSWI) 由于抗生素选择和持续时间不明确,造成了治疗挑战.
- 在DSWI中常见的菌中抗性增加使治疗策略复杂化.
- 目前的抗生素持续时间 (2-6周) 缺乏支持长时间使用的证据.
研究的目的:
- 评估DSWI手术治疗的患者抗生素治疗持续时间的疗效和影响.
- 调查抗生素服用时间和多药耐药性发展之间的关系.
- 评估linezolid对DSWI中常见的グラム阳性病原体的有效性.
主要方法:
- 在2012年至2020年期间,对260名DSWI患者进行了重建性手术的回顾性分析.
- 对抗生素摄入持续时间,微生物扫描结果和耐药性模式的调查.
- 治疗结果与抗生素服用时间和病原体耐药性的相关性.
主要成果:
- 68.1%的患者在出院时获得了闭伤条件.
- 平均抗生素治疗持续时间为21.4天;长期治疗 (>14天) 没有改善结果 (p=0.226).
- 随着长时间使用抗生素,多种药物耐药性显著增加 (p<0.001);线索利德对常见的病原体,如海皮杆菌和黄金杆菌没有耐药性.
结论:
- 对于DSWI,超过14天的抗生素治疗没有提供可证明的益处,并且有助于增加多种药物耐药性.
- 只有在没有传染病或炎症的情况下,手术对DSWI是有效的.
- 利尼佐利德是一种有效的抗生素选择,用于阳性感染,这是最常见的DSWI原因.
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