在多创伤患者中抗生素预防的有效性:系统性审查和元分析
Karolina Dahms1, Kelly Ansems1, Julia Dormann1
1Department of Intensive Care Medicine and Intermediate Care, Medical Faculty, RWTH Aachen University, Aachen, Germany.
概括
在创伤患者中,抗生素预防不会显著影响死亡率,但可能会减少呼吸机相关性肺炎 (VAP). 然而,目前的证据有限,确定性非常低,需要进一步研究.
科学领域:
- 临界护理医学 临界护理医学
- 传染性疾病 传染性疾病
- 创伤外科 手术 创伤外科
背景情况:
- 抗生素预防在创伤护理中是有争议的,因为抗菌素耐药性正在上升.
- 呼吸机相关肺炎 (VAP) 是重症监护室 (ICU) 患者的一个重大问题.
研究的目的:
- 系统地审查抗生素预防的安全性和有效性,与安慰剂或标准护理相比.
- 评估成人多创伤患者的临床结果,包括死亡率和VAP.
主要方法:
- 随机对照试验 (RCT) 和系统审查的系统审查和元分析.
- 搜索了PubMed和Cochrane中央注册到2023年4月20日.
- 包括将抗生素预防与成人多创伤ICU患者的安慰剂/标准治疗进行比较的研究.
主要成果:
- 包括3个RCT,包括256名患者.
- 抗生素预防对所有原因死亡率没有显著影响 (RR 1.01,95% CI 0.55-1.85).
- 证据确定性非常低,数据有限.
结论:
- 抗生素预防可能会降低VAP风险,但对死亡率或临床状况没有重大影响.
- 目前的证据已经过时,确定性非常低,限制了最终的结论.
- 高质量,最新的研究对于明智的临床决策至关重要.
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