对于带有包装的前部表术,是否需要抗生素预防? 来自大型数据库的洞察力
Quincy K Tran1, Isha Vashee2, Rohan Vanga2
1Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States; Research Associate Program in Emergency Medicine & Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, United States; Program In Trauma, The R Adam Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD, United States.
The American journal of emergency medicine
|March 27, 2025
概括
预防性抗生素对接受鼻血前鼻包装的患者提供最小的益处,并可能带来风险. 这项研究发现感染率和不良事件率很低,这表明在这个人群中不应该常规使用抗生素.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 传染性疾病 传染性疾病
- 紧急医疗 紧急医疗
背景情况:
- 前鼻包装 (ANP) 是常见的在急诊室的自发表.
- 预防性抗生素 (Abx) 经常与ANP一起使用,但益处的证据有限.
- 这项研究评估了接受ANP的患者的感染风险,包括或不含预防药物Abx.
研究的目的:
- 为了调查临床显著感染 (CSI) 的患病率,在接受ANP治疗的患者中进行表.
- 评估与预防性Abx使用相关的不良药物事件 (ADE) 的发生率.
- 为了确定预防性抗生素在这个患者群体中的疗效和安全性.
主要方法:
- 一个大型国际数据库 (TriNetX) 的回顾性分析,包括1.3亿名患者.
- 包括接受ANP治疗自发性表观瘤的成年患者.
- 倾向性得分匹配用于比较接受预防性Abx和未接受预防性Abx的患者之间的结果 (30天CSI和ADE).
主要成果:
- 分析包括5487名患者;50%接受了预防性Abx.
- 整体CSI的比率很低 (0.45%).
- 接受和不接受预防性Abx的组之间,CSI (0.5%对0.4%) 和ADE (1%对1%) 的发生率相似,没有统计学上显著的差异.
结论:
- 预防性抗生素在患有ANP的患者中用于表观症,其益处很小.
- 临床意义上的感染和药物不良事件的发生率很低.
- 由于益处和潜在风险有限,不建议常规预防性使用抗生素.
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