与分娩相关的围创伤的抗生素预防:系统性审查和元分析
Hannah Armstrong1, Jane Whitehurst2, R Katie Morris1,3
1Department of Applied Health Sciences, School of Health Sciences, College of Medicine and Health, University of Birmingham, Edgbaston, Birmingham, United Kingdom.
PloS one
|May 9, 2025
概括
预防性抗生素可以减少分娩创伤后围性伤口感染. 然而,需要更多高质量的研究来证实所有女性的这些益处,特别是那些有眼或表皮切割的女性.
科学领域:
- 产科和妇科 产科和妇科
- 预防传染病 预防传染病
- 手术场所感染控制手术场所感染控制
背景情况:
- 与分娩相关的围创伤在阴道分娩中很常见.
- 伤口感染等并发症经常发生.
- 目前的指导方针不建议对所有围外伤类型进行抗生素预防.
研究的目的:
- 评估预防性抗生素在预防所有类型的与分娩相关的围创伤并发症方面的有效性.
- 综合各种研究设计关于抗生素使用的证据.
- 为了告知产后护理指南的潜在变化.
主要方法:
- 随机对照试验,非随机干预研究和观察性研究的系统审查和元分析.
- 从创建到2024年2月的数据库进行了搜索.
- 主要结局是围性伤口感染;用于分析的随机效应模型.
主要成果:
- 包括14项涉及8878名女性的研究,10项具有高偏差风险,GRADE确定性低.
- 预防性抗生素与周围伤感染率的降低有关 (RR 0.57).
- 亚组分析显示,对于非产科性关节损伤和表皮切割,感染风险降低.
结论:
- 预防性抗生素显示与减少周围伤口感染率的关联.
- 没有足够的高质量的证据来改变第一/第二度撕裂或表皮切割的指南.
- 对于患有这些特定围创伤的女性,建议进行大型,强大的随机对照试验.
相关概念视频
Healthcare Associated Infections II: Preventive Measures
4.7K
Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
4.7K
Local Anesthetics: Clinical Application as Epidural Anesthesia
1.0K
Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...
1.0K
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
434
A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
434
Development of Human Microbiota
61
The human microbiota begins developing at birth and undergoes continual change as we age. Infancy marks a critical period of microbial sensitivity, offering a “window of opportunity” during which beneficial microbes help mature the immune system. By age three, children typically develop a more stable and diverse microbial community. Newborns acquire microbes from their immediate environment; vaginal delivery favors maternal vaginal microbes, while cesarean births favor microbes from...
61
Development of the Oral Microbiota
65
The establishment of the oral microbiome begins before birth, challenging the long-held belief that the fetal oral cavity is sterile. The presence of oral microbes such as Streptococcus and Fusobacterium in amniotic fluid suggests that microbial exposure may occur in utero, potentially through translocation from the maternal oral or gastrointestinal tract. This early colonization primes the neonatal immune system and sets the stage for subsequent microbial succession. Maternal health,...
65


