评估培养阳性外伤性开放骨折的预防性抗生素覆盖率。

Rachel LaBianca Toler, Susan E Hamblin, Lauren E Mangan, J Myles Keck, Austin Ing, Matthew Felbinger, Cory Collinge, Bradley M Dennis
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引用次数: 0

摘要

指南对开放性骨折的预防性抗菌治疗提出了不同的建议。这项单中心回顾性队列研究旨在确定机构预防性抗生素方案对开放性骨折相关病原体的覆盖程度。作者纳入了有一处或多处开放性骨折且开放性骨折部位培养阳性的成人创伤患者,并比较了使用预防性抗生素的患者与未使用预防性抗生素的患者的治疗效果。在接受评估的 957 名患者中,有 75 名患者接受了预防性抗生素治疗,其中 40 名患者(53%)接受了预防性抗生素治疗。在预防性抗生素覆盖的患者中,有 23 人(58%)分离出了耐多药病原体,而在未覆盖的患者中,有 26 人(74%)分离出了耐多药病原体(P = 0.128)。与使用初始抗生素的患者相比,未使用初始抗生素的患者培养阳性的中位时间较短(30.2 天 vs. 102.1 天;p = 0.003)。半数以上患者培养出的病原体在最初的抗生素预防中已被覆盖。(外科骨科进展杂志》33(2):084-087,2024 年)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Prophylactic Antibiotic Coverage in Culture-positive Traumatic Open Fractures.

Guidelines provide varying recommendations for the prophylactic antimicrobial treatment of open fractures. This single-center, retrospective cohort study was conducted to determine how well an institutional prophylactic antibiotic protocol covered pathogens associated with open fractures. The authors included adult trauma patients with one or more open fractures and a positive culture from the site of the open fracture, and compared outcomes between patients who were covered by prophylactic antibiotics with patients not covered by prophylactic antibiotics. Of 957 patients evaluated, 75 were included, with 40 patients (53%) covered by the prophylactic antibiotics received. Multidrug-resistant pathogens were isolated in 23 (58%) patients covered versus 26 (74%) patients not covered (p = 0.128). The median time to positive culture was less in patients not covered by initial antibiotics compared with those who were covered (30.2 vs. 102.1 days; p = 0.003). Over half of the patients developed cultures with pathogens that were covered by their initial antibiotic prophylaxis. (Journal of Surgical Orthopaedic Advances 33(2):084-087, 2024).

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