Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz
{"title":"眼窝骨折的抗生素预防。","authors":"Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz","doi":"10.2174/1874364101711010011","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.</p><p><strong>Main outcome measures: </strong>Development of orbital infection.</p><p><strong>Results: </strong>One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received intravenous (IV) antibiotics (excluding cefazolin). Cephalexin and amoxicillin-clavulanate were the most prescribed oral antibiotics that are equally effective. Five-to-seven day courses of antibiotics had no increased infections compared to ten-to-fourteen day courses. Calculated boundaries for effectiveness of prophylactic antibiotics ranged from a Number Needed to Treat (NNT) of 75 to a Number Needed to Harm (NNH) of 198.</p><p><strong>Conclusion: </strong>Antibiotics for prevention of orbital infection in patients with orbital fractures have become widely used. Coordination between trauma teams and specialists is needed to prevent patient overmedication and antibiotic resistance. Should antibiotics be used, shorter courses and avoidance of broad spectrum agents are recommended. Additional studies are needed.</p>","PeriodicalId":46347,"journal":{"name":"Open Ophthalmology Journal","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2174/1874364101711010011","citationCount":"15","resultStr":"{\"title\":\"Antibiotic Prophylaxis in Orbital Fractures.\",\"authors\":\"Benjamin Reiss, Lamise Rajjoub, Tamer Mansour, Tony Chen, Aisha Mumtaz\",\"doi\":\"10.2174/1874364101711010011\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.</p><p><strong>Main outcome measures: </strong>Development of orbital infection.</p><p><strong>Results: </strong>One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received intravenous (IV) antibiotics (excluding cefazolin). Cephalexin and amoxicillin-clavulanate were the most prescribed oral antibiotics that are equally effective. Five-to-seven day courses of antibiotics had no increased infections compared to ten-to-fourteen day courses. Calculated boundaries for effectiveness of prophylactic antibiotics ranged from a Number Needed to Treat (NNT) of 75 to a Number Needed to Harm (NNH) of 198.</p><p><strong>Conclusion: </strong>Antibiotics for prevention of orbital infection in patients with orbital fractures have become widely used. Coordination between trauma teams and specialists is needed to prevent patient overmedication and antibiotic resistance. Should antibiotics be used, shorter courses and avoidance of broad spectrum agents are recommended. Additional studies are needed.</p>\",\"PeriodicalId\":46347,\"journal\":{\"name\":\"Open Ophthalmology Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2017-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.2174/1874364101711010011\",\"citationCount\":\"15\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Open Ophthalmology Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.2174/1874364101711010011\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2017/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q4\",\"JCRName\":\"OPHTHALMOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Ophthalmology Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.2174/1874364101711010011","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2017/1/1 0:00:00","PubModel":"eCollection","JCR":"Q4","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}
Purpose: To determine whether prophylactic antibiotic use in patients with orbital fracture prevent orbital infection.
Design: Retrospective cohort study.
Participants: All patients diagnosed with orbital fracture between January 1, 2008 and March 1, 2014 at The George Washington University Hospital and Clinics.
Main outcome measures: Development of orbital infection.
Results: One hundred seventy-two patients with orbital fracture met our inclusion and exclusion criteria. No orbital infections were documented. Twenty subjects (12%) received no prophylactic antibiotic, and two (1%) received only one dose of antibiotics pre-operatively for surgery. For primary antibiotic, 136 subjects (79%) received oral antibiotics, and 14 (8%) received intravenous (IV) antibiotics (excluding cefazolin). Cephalexin and amoxicillin-clavulanate were the most prescribed oral antibiotics that are equally effective. Five-to-seven day courses of antibiotics had no increased infections compared to ten-to-fourteen day courses. Calculated boundaries for effectiveness of prophylactic antibiotics ranged from a Number Needed to Treat (NNT) of 75 to a Number Needed to Harm (NNH) of 198.
Conclusion: Antibiotics for prevention of orbital infection in patients with orbital fractures have become widely used. Coordination between trauma teams and specialists is needed to prevent patient overmedication and antibiotic resistance. Should antibiotics be used, shorter courses and avoidance of broad spectrum agents are recommended. Additional studies are needed.
期刊介绍：
The Open Ophthalmology Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, letters and guest edited single topic issues in all important areas of experimental and clinical research in ophthalmology, including use of ophthalmological therapies, devices and surgical techniques. The Open Ophthalmology Journal, a peer-reviewed journal, is an important and reliable source of current information on developments in the field. The emphasis will be on publishing quality papers rapidly and making them freely available to researchers worldwide.
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