对儿科复杂尾炎的术后抗生素方案的比较:西方儿科外科研究联盟的一项研究
Utsav M Patwardhan1, Anastasia Kahan2, R Scott Eldredge3
1Division of Pediatric Surgery, Rady Children's Hospital San Diego, San Diego, CA, USA.
对于儿科复杂尾炎的抗生素持续时间没有影响手术部位感染或再入院. 然而,较长的抗生素疗程与放出后排水增加有关,这表明更短的持续时间可能是有益的.
科学领域:
- 儿科手术 儿科手术
- 传染性疾病 传染性疾病
- 临床结果研究研究
背景情况:
- 对于儿童复杂尾炎的最佳术后抗生素持续时间缺乏共识.
- 目前的做法往往依赖于白细胞数量的正常化或固定的治疗持续时间.
- 不同的抗生素方案可能会影响患者的治疗结果.
研究的目的:
- 为了比较与不同手术后抗生素协议相关的临床结果,用于儿科复杂尾炎.
- 评估抗生素持续时间对手术部位感染,再入院和其他并发症的影响.
主要方法:
- 对1342名儿童患者 (<18岁) 进行复杂尾炎的腹腔镜尾切除术 (2021-2023) 的回顾性队列分析.
- 来自9家儿童医院的数据使用国家外科质量改善计划儿科 (NSQIP-P) 数据库.
- 根据排泄抗生素协议分组的患者:没有排泄抗生素,抗生素对WBC升高,抗生素满足最低持续时间,或常规排泄抗生素.
主要成果:
- 在手术部位感染 (5.7-9.8%),急救诊所访问 (9.0-15.6%) 或30天再入院 (2.9-7.6%) 之间没有显著差异.
- 在标准化最低抗生素持续时间组中观察到最高的住院中位数 (5天) 和出院后皮肤通排水率 (9.4%).
- 患者的人口统计学 (年龄,BMI) 在各组中相似.
结论:
- 儿科复杂尾炎的退院抗生素协议没有影响SSI或再入院率.
- 协议化,延长排放的抗生素与排放后排水的更高发病率有关.
- 研究结果表明,有机会减少不必要的血液抽取和长时间使用抗生素.
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