扩大口服抗生素在骨科手术中未能减少手术部位感染:一项比较研究
Alireza Mirahmadi1, Pooya Hosseini-Monfared1, Mehrdad Farrokhi2
1Bone Joint and Related Tissues Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
在整形外科手术中,长时间的口服抗生素不会降低手术部位感染率,可能会增加并发症. 建议进行短期预防以避免不良反应.
科学领域:
- 骨科手术
- 传染病控制
- 药理学
背景情况:
- 手术部位感染 (SSI) 在骨科手术中造成重大负担.
- 预防性抗生素是标准的, 但最佳的持续时间是有争议的.
- 现有的指导方针与最近关于抗生素持续时间的发现相冲突.
研究的目的:
- 为了比较短期 (< 24 小时) 与长期口服抗生素预防的疗效.
- 评估与不同抗生素持续时间相关的术后并发症.
- 确定骨科手术的最佳预防抗生素策略.
主要方法:
- 对骨科手术患者的回顾性分析 (TKA,THA,ACL重建,部固定).
- 患者分为短期 (< 24 小时) 和长期口服抗生素组.
- 组间SSI率 (3个月后) 和不良事件的比较.
主要成果:
- 短期 (2. 8%) 和长期 (4. 6%) 抗生素组之间的SSI率没有显著差异 (P=0. 35).
- 长期使用抗生素与更多的手术后并发症有关 (36. 2% vs 22. 8%,P=0. 004).
- 包括398名患者:246名短期,152名长期使用抗生素.
结论:
- 与短期预防相比,延长时间的口服抗生素不会降低骨科手术中的SSI率.
- 长期使用抗生素与术后并发症的发生率较高有关.
- 这些发现支持将预防性口服抗生素限制在24小时以下的骨科手术.
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