对接受胆囊切除术的儿童的抗微生物预防使用和结果
Kerri A McKie1, Anoosha Moturu2, Dionne A Graham3
1Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts.
JAMA pediatrics
|February 24, 2025
概括
在儿科胆囊切除术中的抗微生物预防显著减少了手术部位感染 (SSIs). 塞法索林与更广泛的抗生素一样有效,这表明了抗菌药物管理的机会.
科学领域:
- 儿科手术 儿科手术
- 传染性疾病 传染性疾病
- 改善外科手术的质量
背景情况:
- 目前针对非复杂胆病的抗微生物预防的指导方针是基于成人数据.
- 儿科手术群体可能对预防有不同的反应.
研究的目的:
- 为了比较手术部位感染 (SSI) 的结果,在接受胆囊切除术的儿童中,有或没有抗菌预防.
- 评估扩展频谱与标准频谱预防的影响.
主要方法:
- 一项对2234名接受胆囊切除术的儿童的队列研究,来自国家外科质量改善计划-儿科的141家医院.
- 倾向性得分权重被用于平衡群体,后勤回归模型估计了预防和结果之间的关联.
- 排除标准包括急性胆囊炎,胰腺炎,胆固醇,血液学疾病和紧急手术.
主要成果:
- 接受预防的儿童相比未接受预防的儿童 (3.7%) 的SSI率明显较低 (0.9%).
- 针对SSI与预防的调整后几率比为0.28 (95% CI,0.11-0.70).
- 在塞法佐林和扩展谱抗生素之间没有观察到SSI发病率的显著差异.
结论:
- 抗微生物预防与在接受非突发性胆囊切除术的儿童中降低SSI率有关.
- 塞法索林似乎与扩展谱抗生素一样有效,用于预防这种人群.
- 有机会优化感染预防和小儿胆囊切除术中的抗菌药物管理.
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