增加了手术部位感染的风险,在干净的骨切割中使用克林达米辛预防.
Samuel Latreille1, Rémy Bernard1, Antoine Abi Lutfallah1
1Department of Anesthesiology and Critical Care, Pitié-Salpêtrière Hospital, AP-HP, Sorbonne University, Paris, France.
Neurosurgery
|September 9, 2025
概括
克林达米辛增加了手术部位感染的风险在干净的骨切割患者. 塞法林仍然是预防手术后中枢神经系统感染的首选抗生素.
科学领域:
- 神经外科 神经外科
- 传染病流行病学 传染病流行病学
- 临床药房 临床药房
背景情况:
- 手术后的中枢神经系统感染是切除术后的一个重要并发症,发病率在2.2%至9.6%之间.
- 手术前的抗生素预防,特别是诸如塞法索林之类的类抗生素,是减少这些感染的标准.
- 对于青素过敏患者,使用了替代抗生素,如万科米辛或克林达米辛,但它们的有效性仍有争议,一些研究将克林达米辛与增加的手术部位感染 (SSI) 联系起来.
研究的目的:
- 为了评估克林达米辛与塞法林相比对手术部位感染 (SSI) 发生率的影响,在接受干净切割的患者中.
- 在这个患者群体中确定SSI的独立风险因素.
主要方法:
- 对接受干净切割的患者的前性监测数据库 (2005-2020) 的回顾性分析.
- 包括12,347名患者,比较塞法林和克林达米辛预防组.
- 应用单变量,多变量和倾向得分匹配分析来评估SSI风险.
主要成果:
- 总体SSI率为2.45%. 这是一个很好的数字. 克林达米辛的使用与SSI的更高风险 (aOR:2.52) 和90天感染修订 (OR:2.09) 有显著的关联.
- 倾向性评分分析证实SSI比率增加 (OR:2.59) 和对克林达米辛感染的修订.
- 独立的SSI风险因素包括男性性别,高ASA得分,长期手术,特定诊断和脑脊液泄漏 (aOR:38.51).
结论:
- 克林达米辛的预防与干净的骨切割手术中SSI的风险增加有关.
- 由于其安全性和有效性,Cefazolin被推为首选的抗生素,即使在青素过敏患者中也是如此.
- 需要对预防方案进行前性评估,以优化术后感染预防策略.
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