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新生儿手术的抗生素预防:基于"少可能更好"的新方案的实施评估

M José Sánchez de Toro¹, Mercedes Sampedro Martín¹, Celia Permuy Romero¹

¹Neonatology service, La Paz University Hospital, Madrid, Spain.

Journal of neonatal-perinatal medicine

|August 30, 2025

概括

一个新的新生儿手术预防方案减少了抗生素的持续时间和剂量,而不会增加手术部位的感染. 这种基于证据的方法对脆弱的新生儿是可行的.

科学领域:

新生儿手术
预防传染病
抗生素管理

背景情况:

手术部位感染 (SSI) 会增加新生儿发病率,死亡率和医疗费用.
新生儿具有不成熟的免疫系统,
新生儿手术预防的证据有限,需要广泛,扩展的抗生素使用.

研究的目的:

评估新生儿手术预防方案的影响.
将抗生素的使用限制在特定的指示和有限的持续时间内.
将新生儿预防与儿科和成人群体的证据相一致.

主要方法:

一项病例控制研究将新方案 (2022 年 3 月至 2023 年 3 月) 与历史控制方法 (2019 年 3 月至 2020 年 3 月) 进行了比较.
分析了围产,手术和预防性抗生素变量,包括协议遵守和传染性并发症.
包括90个干预组中的程序和116个控制组中的程序.

主要成果:

新方案显著减少了抗生素治疗的持续时间 (72小时而不是48小时) 和累计剂量.
没有观察到感染并发症的增加 (6. 4% vs 10. 1%, p=0. 343).
患者和手术特征在各组之间是可比的.

结论:

对于新生儿来说,使用更狭窄,更短时间的手术预防方案是安全的.
这种方法并没有提高这一群体中与手术相关的感染的发生率.
在多学科环境中制定和实施该议定书是可行的.

关键词:

手术部位感染抗生素预防新生儿学新生儿进行手术

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