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抗生素前期治疗对术后并发症的影响 牙提取后的术后并发症
Jessina C McGregor1, Geneva M Wilson2,3, Gretchen Gibson4,5
1Department of Pharmacy Practice, College of Pharmacy, Oregon State University, Portland, Oregon, USA.
Journal of public health dentistry
|August 12, 2024
概括
在一项大型退伍军人事务研究中,抗生素预防并没有显著减少提取后并发症. 这些发现建议重新评估常规抗生素使用,以尽量减少不必要的处方和潜在的耐药性.
科学领域:
- 牙科手术是指牙科手术.
- 传染病流行病学 传染病流行病学
- 医疗服务研究 医疗服务研究
背景情况:
- 抗生素预防通常用于牙提取,以防止并发症.
- 支持其在所有接受牙拔牙的患者的常规使用的证据仍在争论中.
- 了解抗生素预防对不良结果的实际影响对于优化临床实践至关重要.
研究的目的:
- 评估抗生素预防与拔牙后不良结果之间的关联.
- 为了确定抗生素使用是否影响提取后并发症或随后的医疗护理.
- 为了研究患者因子 (如糖尿病) 的潜在效果修改.
主要方法:
- 在2015-2019年期间接受牙提取的患者的回顾性队列研究.
- 主要暴露:抗生素预防. 主要结局:提取后并发症在7天内.
- 多变量后勤回归用于分析抗生素预防的效果,并对糖尿病的混因子和效果修改分析进行调整.
主要成果:
- 分析了超过3.8万5千件牙提取;31.8%接受了抗生素预防.
- 提取后并发症发生在0.9%的病例中.
- 抗生素预防与非糖尿病患者 (OR=1.25) 的并发症概率增加有关,但与糖尿病患者 (OR=1.03) 的并发症概率增加无关. 没有发现与随后的医疗护理有显著的关联.
结论:
- 在这种低并发症的环境中,没有观察到抗生素预防对提取后并发症或医疗保健利用的显著保护作用.
- 这些发现表明,常规抗生素预防可能没有益处,可能导致不必要的抗生素暴露.
- 重新评估牙提取抗生素预防指南是有必要的,以减少过度使用和减轻抗菌素耐药性的担忧.
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