没有增加的感染风险 随着协议的改变,以减少术后抗生素预防的时间在肝移植肝脏移植
Hutton Brandon1, Crystal M Truax2, Eduardo Rodriguez Zarate3
1Division of Infectious Diseases, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.
概括
缩短肝移植接受者的抗生素预防并没有增加感染率. 这种变化可能会减少与抗生素相关的并发症,改善患者的治疗结果和安全.
科学领域:
- 移植医学 移植医学
- 传染病控制和控制传染病
- 药理学 药理学是指药理学的学科.
背景情况:
- 肝移植接受者面临细菌手术部位感染 (SSI) 的高风险.
- 这些患者也容易发生抗生素并发症,包括Clostridioides difficile和耐药生物体感染.
- 在肝移植中,术后抗生素预防的最佳持续时间尚不清楚.
研究的目的:
- 评估缩短抗生素预防方案对肝移植患者感染率和并发症的影响.
- 为了确定减少抗生素暴露是否会增加SSI或细菌病风险.
- 评估协议更改对其他不良结果的影响.
主要方法:
- 分析了192名肝移植患者在协议更改之前和之后的感染结果.
- 风险分层的抗生素预防持续时间,移植前住院患者的时间较长.
- 协议更改:预防措施从5天减少到3天 (移植前住院) 和2天减少到1天 (其他).
主要成果:
- 没有观察到SSI或细菌病率的显著增加.
- 多变量分析显示,SSI或细菌病风险没有显著增加 (OR 0.50,95% CI 0.07-2.24;p=0.41).
- 在再接收,移植排斥,移植失败,死亡率,急性损伤,C. difficile感染或耐药生物体发展方面没有显著差异.
结论:
- 在肝移植中缩短术后抗生素预防的持续时间是安全的.
- 这种策略不会增加感染风险,并且可以减轻与抗生素相关的危害.
- 这些发现支持对肝移植患者的抗生素预防指南的修订.
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