Whittem T L, Johnson A L, Smith C W, Schaeffer D J, Coolman B R, Averill S M, Cooper T K, Merkin G R
Department of Veterinary Biosciences, College of Veterinary Medicine, University of Illinois, Urbana 61802, USA.
J Am Vet Med Assoc. 1999 Jul 15;215(2):212-6.
To determine whether perioperative antimicrobial prophylaxis would reduce incidence of postoperative infection among dogs undergoing elective orthopedic procedures.
Randomized, controlled, blinded, intention clinical trial.
Dogs of any breed, sex, or age undergoing elective orthopedic surgery at a veterinary teaching hospital.
Dogs were randomly assigned to 1 of 3 groups: treatment with saline solution, treatment with potassium penicillin G, and treatment with cefazolin. Treatments were intended to be administered within 30 minutes prior to surgery; a second dose was administered if surgery lasted > 90 minutes. Dogs were monitored for 10 to 14 days after surgery for evidence of infection.
After the first 112 dogs were enrolled in the study, it was found that infection rate for control dogs (5/32 dogs) was significantly higher than the rate for dogs treated with antimicrobials (3/80 dogs). Therefore, no more dogs were enrolled in the study. A total of 126 dogs completed the study. Monte Carlo simulations indicated that compared with dogs that received antimicrobials prophylactically, dogs that received saline solution developed infections significantly more frequently. Difference in efficacy, however, was not observed between the 2 antimicrobial drugs used.
Results indicated that perioperative antimicrobial prophylaxis decreased postoperative infection rate in dogs undergoing elective orthopedic surgery, compared with infection rate in control dogs. Cefazolin was not more efficacious than potassium penicillin G in these dogs.
确定围手术期抗菌药物预防性应用是否会降低接受择期骨科手术的犬类术后感染的发生率。
随机、对照、双盲、意向性临床试验。
在一家兽医教学医院接受择期骨科手术的任何品种、性别或年龄的犬类。
将犬随机分为3组中的1组：生理盐水治疗组、青霉素G钾治疗组和头孢唑林治疗组。治疗药物打算在手术前30分钟内给药；如果手术持续时间超过90分钟，则给予第二剂。术后对犬进行10至14天的监测，以寻找感染证据。
在该研究纳入首批112只犬后，发现对照组犬（32只犬中有5只）的感染率显著高于接受抗菌药物治疗的犬（80只犬中有3只）。因此，未再纳入更多犬参与该研究。共有126只犬完成了该研究。蒙特卡洛模拟表明，与预防性接受抗菌药物的犬相比，接受生理盐水治疗的犬发生感染的频率显著更高。然而，在所使用的两种抗菌药物之间未观察到疗效差异。
结果表明，与对照组犬的感染率相比，围手术期抗菌药物预防性应用降低了接受择期骨科手术的犬的术后感染率。在这些犬中，头孢唑林并不比青霉素G钾更有效。
