常见的实证抗生素疗法与克洛斯特里类药物之间的关联 在儿科尾炎中难以感染
Andrew Hu1, Yao Tian1, Lynn Huang1
1Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
Journal of pediatric surgery
|December 13, 2023
概括
在小儿尾炎手术后,难以感染的闭膜炎 (CDI) 是罕见的. 皮佩拉西林和塔佐巴克坦 (PT) 与塞夫特里亚克松和美特罗尼达 (CM) 相比,显示了较低的CDI率,突出了抗生素管理需求.
科学领域:
- 儿科外科手术 儿科外科手术
- 传染病 传染病 传染病
- 抗生素管理的管理.
背景情况:
- 艰难闭膜炎感染 (CDI) 是治疗尾炎的儿童的一个重要并发症.
- 了解不同实证抗生素疗法的CDI风险对于有效的抗生素管理至关重要.
研究的目的:
- 为了比较三种常见的经验抗生素治疗方案中急性尾炎的尾切除术后CDI的可能性.
- 评估抗生素选择和暴露对儿童尾炎患者的CDI率的影响.
主要方法:
- 对105,911名接受尾切除手术的儿科患者 (年龄在1-18岁) 的回顾性队列研究.
- 塞夫特里亚克松和美特罗尼达 (CM),皮佩拉西林和塔佐巴克坦 (PT) 以及塞福西疗法的比较.
- 在尾切除术后28天内对CDI进行分析,并在尾切除术后30天内进行皮肤通排水.
主要成果:
- CDI发生在0.21%的患者中,CM (0.29%) 与PT (0.15%) 和Cefoxitin (0.18%) 相比,CM的发病率更高.
- 与CM (OR,0.48) 相比,Piperacillin & Tazobactam (PT) 与CDI的可能性显著降低.
- 增加抗生素治疗方案的多样性和持续时间与更高的CDI风险相关;在排水程序中没有观察到差异.
结论:
- 在小儿尾切除术后,CDI很少发生.
- 皮佩拉西林和塔佐巴克坦 (PT) 显示了较低的CDI发病率比塞夫特里亚克松和美特罗尼达 (CM).
- 抗生素管理应专注于尽量减少混合疗法和减少整体抗生素暴露,以防止CDI.
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