Kazutaka Uchida, Keita Takahama, Kenshiro Higashi, Yuki Kusano, Koki Matsumoto, Yoshihiro Nakagawa, Kazutaka Oda
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引用次数: 0
摘要
背景:白内障手术每年都在增加,因此适当的医疗管理至关重要。常规使用全身抗菌药预防手术部位感染缺乏有力证据,可能会增加耐药菌和不良事件的风险。本研究探讨了在白内障手术围手术期停止使用头孢唑啉(CEZ)对术后不良事件发生率和医疗费用的影响:住院白内障手术患者分为两组:使用CEZ组(2021年4月至2022年3月)和不使用CEZ组(2022年4月至2023年3月)。主要终点是不良事件发生率和医疗费用,次要终点是眼内炎发生率:CEZ组共有265名患者,非CEZ组共有316名患者。CEZ组发生了6起术后不良事件(2.3%,95%置信区间:0.8-4.9),预计每1万名使用CEZ的患者中会有230名患者发生不良事件(95%置信区间为80-490)。非 CEZ 组未发生不良事件,药物费用减少了约 46,000 日元。保险索赔金额也有所减少。两组患者均未发现术后早期眼内炎病例:结论:在白内障手术围手术期停用 CEZ 可有效降低不良事件的风险。试验登记:回顾性注册。
Impact of discontinuation of cephazolin prophylaxis on the incidence of postoperative adverse events in cataract surgery.
Background: Cataract surgeries are increasing annually, making appropriate medical management essential. The routine use of systemic antimicrobial agents for preventing surgical site infections lacks strong evidence and may increase the risk of drug-resistant bacteria and adverse events. This study examined the impact of discontinuing cefazolin (CEZ) administration during the perioperative period of cataract surgery on the incidence of postoperative adverse events and medical costs.
Methods: Inpatient cataract surgery patients were divided into two groups: the CEZ-use group (April 2021 to March 2022) and the non-CEZ-use group (April 2022 to March 2023). The primary endpoints were the incidence of adverse events and medical costs, while the secondary endpoint was the incidence of endophthalmitis.
Results: A total of 265 patients were in the CEZ group, and 316 were in the non-CEZ group. Six postoperative adverse events (2.3%, 95% confidence interval: 0.8-4.9) occurred in the CEZ group, with an estimated 230 patients (80-490 from the 95% confidence interval) expected to experience adverse events per 10,000 patients using CEZ. The non-CEZ group had no adverse events and reduced drug costs by approximately 46,000 yen. Insurance claim amounts were also reduced. No cases of early postoperative endophthalmitis were observed in either group.
Conclusions: Discontinuation of CEZ prophylaxis during the perioperative period of cataract surgery effectively reduced the risk of adverse events. Medical for the period after discontinuing CEZ did not increase.