在全关节整形术中,抗菌素预防的持续益处:十年的回顾性分析
Itay Ashkenazi1,2, Weston Buehring1, Armin Arshi1
1Department of Orthopaedic Surgery, NYU Langone Health, New York, NY, USA.
概括
在全关节整形手术 (THA) 之前,添加基因负特异性覆盖 (GNSC) 基因素或阿兹特里诺显著减少了基因负周围假肢关节感染 (PJIs). 轻度毒性增加,但严重的损伤和衰竭率仍然相似.
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:
- 十年前,一个机构更新了其全关节整形手术 (THA) 术前抗生素协议,以包括格兰阴性 (GN) 覆盖.
- 这项研究评估了添加格兰阴性特异性覆盖 (GNSC) 对THA后周围假肢关节感染 (PJI) 率的影响.
研究的目的:
- 评估GNSC在THA后降低PJI费率方面的有效性.
- 评估与THA患者的GNSC相关的安全性,特别是毒性.
主要方法:
- 追溯病例控制研究涉及14598名接受初级选择性THA治疗的患者 (2012年7月 - 2022年1月).
- 与接受GNSC (gentamicin或aztreonam) 的患者和没有GNSC的历史对照组之间的比较.
- 分析包括PJI率,致病生物和毒性严重程度 (RIFLE标准).
主要成果:
- 在GNSC组中,与GN相关的PJI比例较低 (10.64%对26.53%,p=0.014).
- 由阳性细菌引起的PJIs的比例在各组之间是相似的 (87.67%与83.67%,p=0.532).
- 在GNSC组中,毒性率较高 (2.87%对1.78%,p=0.003),但严重损伤和衰竭率相似.
结论:
- 周周手术GNSC (gentamicin或aztreonam) 有效地降低了THA.中GN相关的PJIs的发生率.
- 观察到的毒性增加主要是轻微的和可逆的,严重的损伤或功能衰竭没有显著差异.
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