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单剂量与一日量头孢唑林在妇科手术预防应用中的前瞻性随机对照研究

Prospective randomized comparison of single-dose versus 1-day cefazolin for prophylaxis in gynecologic surgery.

作者信息

Su Her-Young, Ding Dah-Ching, Chen Da-Chung, Lu Mei-Fen, Liu Jah-Yao, Chang Feng-Yee

机构信息

Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Acta Obstet Gynecol Scand. 2005 Apr;84(4):384-9. doi: 10.1111/j.0001-6349.2005.00583.x.

Abstract

BACKGROUND

The purpose of this prospective, randomized study was to compare the efficacy of single-dose versus 1-day cefazolin prophylaxis for the prevention of postoperative gynecologic infections.

METHODS

From June 2001 to January 2003, 548 patients were randomized to receive either single-dose (1 g of cefazolin intravenously before surgery, 273 patients) or 1-day cefazolin (1 g intravenously before surgery and three more doses every 6 hr after surgery, 275 patients) prophylaxis.

RESULTS

A total of 531 (267 patients in the single-dose group and 264 in the 1-day group) completed the study. Only one of 267 (0.37%) patients in the single-dose group developed a trocar wound infection and one of 264 (0.37%) patients in the 1-day group developed a vaginal cuff infection. Had a single dose of prophylactic antibiotics been administered to all patients, the antibiotic cost would have been reduced by 75-80%.

CONCLUSIONS

The use of single-dose preoperative cefazolin prophylaxis was as effective as four doses of cefazolin for preventing serious infectious morbidity among our patients. Shortening the duration of antibiotics prophylaxis also reduced medical costs and microorganism resistance.

摘要

背景

这项前瞻性随机研究的目的是比较单剂量与1天剂量头孢唑林预防术后妇科感染的疗效。

方法

2001年6月至2003年1月,548例患者被随机分为接受单剂量(术前静脉注射1g头孢唑林,273例患者)或1天剂量头孢唑林(术前静脉注射1g,术后每6小时再注射3剂,275例患者)预防。

结果

共有531例(单剂量组267例,1天剂量组264例)完成研究。单剂量组267例患者中有1例(0.37%)发生套管针伤口感染,1天剂量组264例患者中有1例(0.37%)发生阴道残端感染。若对所有患者均给予单剂量预防性抗生素,抗生素费用将降低75 - 80%。

结论

在我们的患者中,术前使用单剂量头孢唑林预防与使用四剂头孢唑林预防严重感染性发病的效果相同。缩短抗生素预防时间还降低了医疗费用和微生物耐药性。

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