进行过尿道切除前列腺的男性的抗生素预防:系统性审查和网络元分析
Alessandro V Oliveira1,2, Ana Luiza N Sampaio1,2, Edson Luis B Siqueira1
1Department of Medicine, University of Pará State, Belém, Brazil.
概括
抗生素预防 (ATBp) 显著降低了感染风险,包括细菌性尿病和败血症,经过尿道切除前列腺 (TURP). 不同的抗生素类别具有不同的有效性,指导最佳预防策略.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 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:
- 通过尿道切除前列腺 (TURP) 是一种常见的手术,具有术后感染的风险.
- 抗生素预防 (ATBp) 通常用于减轻这些风险,但最佳选择需要基于证据的排名.
研究的目的:
- 为了分析抗生素预防的疗效 (ATBp) 前通过尿道切除前列腺 (TURP).
- 根据不同类型的抗生素在预防TURP相关并发症方面的有效性进行排名.
主要方法:
- 对多个数据库 (PubMed,Web of Science,Embase,CENTRAL) 和临床试验注册表进行了系统的搜索,对随机对照试验 (RCT) 进行了搜索,直到2024年10月.
- 对45个RCT (n=6939) 进行了频率网络元分析,将ATBp与安慰剂/无药剂以及彼此进行比较,估计风险比率和平均差异.
- 治疗方法使用累积排名 (SUCRA) 下的表面被排名,以确定表现最好的抗生素类别.
主要成果:
- 与安慰剂或无药剂相比,ATBp显著降低了早期和晚期细菌性尿,败血症/细菌性尿和发烧的风险.
- 与ATBp一起,也观察到住院时间的缩短.
- 在ATBp和安慰剂/无药剂组之间的死亡率或不良反应中没有发现显著差异.
- 特定的抗生素疗法在不同的结果中表现出优异的排名,例如第1代头素加上早期细菌性尿和发烧的酸.
结论:
- 在TURP程序中的大多数终点中,抗生素预防优于安慰剂或无药剂.
- 选择抗生素类别显著影响疗效,需要仔细考虑最佳预防.
- 建议在 TURP 之前进行常规的 ATBp,以不同类型抗生素的排名有效率为指导.
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