如何让外科医生在手术前选择最合适的抗生素预防与治疗在儿科急性尾炎?
Grazia Spampinato1, Chiara Virgillito2, Filippo Ghidini3
1U.O.C di Chirurgia Pediatrica, A.O.U. Policlinico di Modena, 71 Via del Pozzo, 41121, Modena, Italy. grazia_grazia@hotmail.it.
这项研究确定了C反应蛋白 (CRP) 水平和中性粒细胞百分比作为区分儿童简单尾炎和复杂尾炎的关键指标. 在手术前,CRP截止值为4.2 mg/dl可以指导抗生素选择.
科学领域:
- 儿科手术 儿科手术
- 医学诊断 医学诊断 医学诊断
背景情况:
- 急性尾炎需要及时和适当的治疗.
- 在手术前区分简单和复杂的尾炎对于有效的抗生素管理至关重要.
研究的目的:
- 建立在儿科患者中急性尾炎的术前分类的统计学上有效的标准.
- 根据尾炎的类型来指导选择最佳的抗生素预防和治疗.
主要方法:
- 120名接受尾切除手术的儿科患者 (0-14岁) 的回顾性评估.
- 通用线性模型 (GLM) 分析以确定尾炎类型的预测变量 (CRP,中性粒细胞,WBC).
- 主要组件分析 (PCA) 用于确定显著变量的截止值.
主要成果:
- 细胞C反应蛋白 (CRP) 和中性粒细胞百分比是尾炎类型的显著预测因素.
- 较低的CRP和中性粒细胞百分比与简单的尾炎有关.
- PCA发现CRP的切线为4.2 mg/dl (AUC84%) 和中性粒细胞百分比为80.1% (AUC70%),用于分类.
结论:
- 手术前的CRP切线值为4.2 mg/dl,可以帮助区分简单的尾炎和复杂的尾炎.
- 这一发现支持量身定制的抗生素策略:在CRP<4.2 mg/dl时使用塞法佐林,在CRP>4.2 mg/dl时使用阿莫西西林-克拉夫兰酸.
更多相关视频
11:17Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
09:17A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii
Published on: January 2, 2017
相关概念视频
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Antibiotic Selection
Tonsillitis II: Management
Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
