单独使用塞法索林对抗塞法索林与托布拉米辛或甘塔米辛作为整关节整形关节整形术的手术内抗生素预防
Meera M Dhodapkar1, Scott J Halperin1, Zachary Radford1
1Yale School of Medicine, Department of Orthopaedics and Rehabilitation, New Haven, CT, USA.
Arthroplasty today
|February 6, 2025
概括
将氨基糖化物添加到全膝关节和关节整形手术的塞法林预防中,不会降低感染或修复率. 在这些手术中,单独使用标准的塞法索林是有效预防假肢关节感染的.
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:
- 假肢关节感染在全膝关节整形术 (TKA) 和全关节整形术 (THA) 后是一个重要的风险.
- 塞法索林是标准的预防性抗生素,但已经考虑添加氨基糖化物 (gentamicin 或 tobramycin).
研究的目的:
- 评估添加氨基糖化物添加到塞法林预防中的有效性,以预防TKA和THA后的不良结果.
- 为了比较90天的术后不良结果和接受单独塞法林治疗的患者与服用塞法林加氨基糖化物治疗的患者之间的5年植入物存活率.
主要方法:
- 对2010-2021年成人原发性THA和TKA患者进行了回顾性分析.
- 患者被分为两组:单独使用塞法佐林和塞法佐林加上健塔米辛/托布拉米辛.
- 包括手术部位感染 (SSI) 和植入物修订率在内的结果使用多变量逻辑回归和卡普兰-梅尔分析进行了评估.
主要成果:
- 这项研究确定了32882名THA和119611名TKA患者.
- 对于THA和TKA,在抗生素组之间没有观察到90天不良结果或5年植入物存活率的显著差异.
- 总体上,THA的SSI率为1.1%,TKA的SSI率为0.8%.
结论:
- 对于全关节和膝关节整形手术,将珍塔或托布拉米添加到塞法林预防中并没有改善结果.
- 单一治疗Cefazolin在预防假肢关节感染和确保长期植入物存活方面与联合治疗一样有效.
相关概念视频
01:22Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
246
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
246
01:15Determination of Multiple Dosing Parameters: Steady-State, Minimum and Maximum Concentrations
335
Gentamicin, an aminoglycoside antibiotic, is commonly administered via intermittent intravenous infusion to treat severe infections. An intermittent one-hour infusion of gentamicin, administered at eight-hour intervals, allows for precise control of plasma drug concentrations, minimizing toxicity while ensuring therapeutic efficacy. Pharmacokinetic principles govern the dynamics of plasma concentrations and can be mathematically described using specific equations.The plasma drug concentration...
335
01:28Inhibitors of Bacterial DNA Synthesis
54
Bacterial pathogens depend on precise and efficient DNA replication to sustain infection. Two type II topoisomerases—DNA gyrase and topoisomerase IV—are critical to this process, as they resolve DNA supercoiling and unlink chromosomes during replication. Fluoroquinolones, synthetic derivatives of quinolones, exploit this mechanism by stabilizing the transient DNA–enzyme cleavage complex, preventing strand religation, and causing lethal double-strand breaks. These...
54