抗生素对于计划重新拉皮切除术的患者,因为腹部内感染
Lauren J Hochstetler1, William J Olney1,2, Jacqueline M Bishop1,2
1Department of Pharmacy Services, University of Kentucky HealthCare, Lexington, Kentucky, USA.
Surgical infections
|February 26, 2024
概括
较短的抗生素疗程 (≤5天) 对于需要计划重新拉巴切除的腹内感染 (IAI),与较长的疗程相比,没有增加复发风险. 这一发现支持在复杂的IAI病例中优化抗菌药物治疗持续时间.
科学领域:
- 传染性疾病 传染性疾病
- 手术感染 手术感染
- 抗微生物药物管理委员会
背景情况:
- 腹腔内感染 (IAI) 的管理需要适当的抗菌药物治疗,并且有越来越多的证据表明最佳持续时间.
- STOP-IT试验建议IAI的抗生素疗程缩短,但排除了需要重新拉巴切除术的患者.
- 确定计划重新拉巴切除术的患者中较短的抗生素疗程相关的复发风险至关重要.
研究的目的:
- 评估计划性重新拉巴切除术管理的患者中复发性腹腔内感染 (IAI) 的短期和长期风险.
- 为了比较接受短期 (≤5天) 与长期 (>5天) 抗菌药物治疗的患者之间的IAI复发率.
- 评估抗微生物药物治疗持续时间对这一特定患者群体的二次结果的影响.
主要方法:
- 一个单一中心,回顾性,观察性研究对IAI需要计划性腹腔切除术的成年患者进行.
- 在源控制后,患者被分为短期 (≤5天) 和长期 (>5天) 抗微生物治疗组.
- 主要结局是IAI在30天内复发,并分析了次要结局.
主要成果:
- 在104名符合条件的患者中,分析了78名患者. 基线特征和临床严重程度在各组之间相似.
- 在短期和长期抗微生物治疗组之间没有观察到IAI复发的显著差异 (41.2%对44.4%;p=0.781).
- 在二次结果方面,两组之间没有发现差异.
结论:
- 在IAI患者中,经过计划的重新拉巴切除术,短期抗菌药物治疗并没有导致IAI复发的风险增加.
- 这些发现表明,较短的抗微生物药物持续时间可能在选择的IAI患者中安全有效,需要计划的重新拉巴切除术.
- 进一步的研究可能会完善复杂腹部内感染的抗菌药物管理指南.
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