关节整形术后的预防性抗生素额外剂量:有任何好处吗?
James Adeosun1, Essam Rama1, Azeem Thahir2
1School of Clinical Medicine, University of Cambridge, Cambridge, UK.
Journal of perioperative practice
|June 15, 2024
概括
在整体关节置换术后给予额外的预防性抗生素通常没有好处. 然而,对于高风险患者或在有高甲素耐药黄金葡萄球菌流行率的地区,可以考虑额外的剂量.
科学领域:
- 整形外科手术 整形外科手术
- 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:
- 针对全关节置换 (TJR) 的预防性抗生素指南表现出显著的变化.
- 手术部位感染仍然是TJR衰竭的主要原因,增加医疗保健成本并降低患者满意度.
研究的目的:
- 为了评估术后额外的抗生素剂量的有效性,超出当前标准的协议.
- 评估扩展预防方案对感染率,患者成本和毒性风险的影响.
主要方法:
- 对TJR中各种预防性抗生素治疗方案相关的感染率现有证据的全面审查.
- 对比标准与扩展的抗生素预防方案的研究分析.
主要成果:
- 目前的证据不支持对大多数患者进行关节切除术后常规给予额外的抗生素剂量.
- 延长预防的潜在益处可能存在于感染风险较高的个体或在患有甲基西林耐药黄金葡萄球菌 (MRSA) 流行率较高的地区.
结论:
- 通常不建议在TJR后进行常规延长的抗生素预防.
- 考虑到个体患者的风险因素和局部MRSA患病率的量身定制方法可能需要进一步使用抗生素.
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