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JAMA Surg:术后抗菌药物治疗时间与不良预后

2019-04-28 MedSci MedSci原创

研究认为,延长术后抗菌药物预防治疗时间与更高的AKI和艰难梭菌感染风险有关,且持续时间延长不会导致额外的SSI降低

一般在术后24小试内患者需接受抗菌药物预防治疗,近日研究人员对延长抗菌药物预防的危害进行了考察,以探讨手术部位感染(SSI)、急性肾损伤(AKI)和艰难梭菌感染与预防类型和持续时间的关系。

研究人员考察了国家退伍军人事务保健系统中接受心脏、骨科全关节置换、结直肠和血管手术的患者数据,考察术后抗菌药物预防持续时间(<24小时,24-<48小时,48-<72小时,≥72小时)与SSI,AKI和艰难梭菌感染的相关性。

79058名患者参与研究,平均年龄为64.8。多因素调整后,SSI与预防持续时间无关,但的预防措施每增加一天,AKI风险增加(心脏手术:24~48小时:AOR=1.03;48-<72小时:AOR=1.22;≥72小时:AOR=1.82。非心脏手术:24-<48小时:AOR=1.31;48-<72小时:AOR=1.72;≥72小时:AOR=1.79)。手术后艰难梭菌感染的风险表现出相似的持续时间依赖关系(24~<48小时:AOR= 1.08;48~<72h:AOR=2.43;≥72h:AOR=3.65)。万古霉素治疗是AKI的重要危险因素(心脏手术:AOR=1.17;非心脏手术:AOR=1.21)。

研究认为,延长术后抗菌药物预防治疗时间与更高的AKI和艰难梭菌感染风险有关,且持续时间延长不会导致额外的SSI降低。

原始出处:


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    2019-05-17 zwjnj2

    努力学习天天学习

    0

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    2019-04-30 lhlxtx
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    2019-04-28 天地飞扬

    了解一下,谢谢分享!

    0

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