通过证据,问责制和多学科的管理,优化在儿科手术中抗菌预防的使用
Matthew T Hey1, Shawn J Rangel2
1Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Seminars in pediatric surgery
|March 6, 2026
概括
对抗微生物药物的管理对于儿科手术至关重要. 本综述概述了优化手术抗微生物预防 (SAP) 使用,减少过度使用和改善儿童患者结果的策略.
科学领域:
- 儿科手术 儿科手术
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 手术抗微生物预防 (SAP) 的使用在儿科手术中不一致.
- 在儿童医院过度使用抗生素会给公众健康带来风险.
研究的目的:
- 综合证据和指导方针,为儿童外科护理中适当的SAP提供指导.
- 为优化抗生素使用和最大限度地减少小儿手术患者暴露提供路线图.
主要方法:
- 审查国家指导方针和当代成果数据.
- 整合基准测试举措 (例如,ACS NSQIP-儿科).
- 强调抗菌药物管理计划 (ASP) 的作用.
主要成果:
- SAP实践非常多变,在儿科外科设置中经常被过度使用.
- 基准测试和ASP促进了外科手术期间抗生素使用的问责制和标准化.
- 基于证据的工具和策略可以促进预防的高质量管理.
结论:
- 优化SAP对于安全有效的儿科外科护理至关重要.
- 需要采用包括指导方针,数据和ASP在内的综合方法,以尽量减少不必要的抗生素暴露.
- 实施基于证据的策略可以改善管理和患者的结果.
相关概念视频
Pharmacokinetics in Pediatric Patients: Drug Excretion
343
In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
343
Hand hygiene
6.4K
Asepsis is the practice of preventing or breaking the chain of infection. The nurse employs aseptic techniques to prevent the spread of microorganisms and reduce the risk of diseases. Hand hygiene is the cornerstone of aseptic techniques and is classified into medical and surgical asepsis. Medical asepsis includes hand hygiene and the use of gloves. Surgical asepsis, or the sterile technique, refers to practices that render and keep objects and areas free of microorganisms.
Hand washing...
Hand washing...
6.4K
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
583
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
583
Pharmacokinetics in Pediatric Patients: Drug Metabolism
304
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
304
Transmission-based Precautions II: Airborne and Protective Environment
2.1K
Transmission-based precautions are for patients infected or suspected to be infected (or colonized) with organisms posing a significant risk to others. The transmission precautions include airborne and protective environment precautions.
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
2.1K
Pharmaceutical Alternatives: Stability-Related Therapeutic Nonequivalence
235
Generic intravenous (IV) drugs are considered bioequivalent to their branded counterparts due to their 100% bioavailability upon administration. However, variations in stability among different drug products can significantly influence their therapeutic performance, even if they are pharmaceutically equivalent.Cefuroxime, a prophylactic antimicrobial, is often used as a single-dose IV injection for patients undergoing coronary artery bypass grafting surgery. A 3 g dose typically provides...
235


