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β-Lactam与非β-Lactam 抗微生物预防和手术部位感染
Selina Largiadèr1, Delphine Berthod2, Andreas Widmer3
1Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
JAMA network open
|October 31, 2025
概括
非β-乳糖手术抗菌预防 (SAP) 与与β-乳糖SAP相比,与手术部位感染 (SSI) 的风险更高有关. 如果可能的话,尽量避免非β-乳酸盐SAP,特别是在报告过敏的患者中.
科学领域:
- 传染性疾病 传染性疾病
- 临床医学 临床医学
- 手术护理 手术护理
背景情况:
- β-乳酸抗生素是外科抗微生物预防 (SAP) 的标准.
- 非β-乳酸盐SAP作为一种替代品,主要用于患有β-乳酸盐过敏的患者.
- 非β-乳酸糖SAP与手术部位感染 (SSI) 率之间的关联需要进一步澄清.
研究的目的:
- 为了确定非β-乳酸是否与与β-乳酸相比,与SSI的风险增加有关.
- 评估不同非β-乳糖抗生素对SSI率的影响.
主要方法:
- 使用瑞士noso SSI监控系统 (2009-2020) 进行的一项大型队列研究.
- 包括接受重大手术的成年患者,在切口前120分钟内接受SAP.
- 混合效应物流回归模型被用于分析SSI发生,调整混因素.
主要成果:
- 非β-乳酸的SAP给了1.7%的患者,而β-乳酸的SAP给了98.3%.
- 与接受非β-乳糖SAP (2.8%) 患者相比,接受非β-乳糖SAP的患者的SSI率显著更高 (6.1%).
- 非β-乳糖SAP与SSI的几率增加了1.78倍,观察到西普罗夫洛克萨,万科米和克林达米的风险更高.
结论:
- 非β-乳糖手术抗微生物预防与手术部位感染的风险显著增加有关.
- 这些发现表明,在可行的情况下,应避免非β-乳糖SAP.
- 在给予替代抗生素之前,仔细评估报告的β-乳酸过敏患者至关重要.
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