Jenkins P J, Teoh K, Simpson P M, Dave J, Simpson A H W R, Breusch S
Department of Orthopaedic, Surgery, Royal Infirmary of Edinburgh, Old Dalkeith Road, Edinburgh, EH16 4SU, UK.
J Bone Joint Surg Br. 2010 Jul;92(7):994-8. doi: 10.1302/0301-620X.92B7.23412.
Antibiotic prophylaxis is routinely administered during joint replacement surgery and may predispose patients to Clostridium difficile-associated disease (CDAD). The primary aim of this study was to determine the incidence of this following joint replacement, using a cefuroxime-based regimen. Patients developing CDAD were compared with a control group of patients without CDAD. The incidence of the former was 1.7 per 1000 primary joint replacements. Those patients prescribed additional antibiotics had a higher incidence of CDAD (p = 0.047), but there was no difference between the two groups in relation to the use of gastroprotective agents (p = 0.703). A trial of a new prophylaxis regimen would require 43 198 patients in each arm to show a reduction of one case per 1000 procedures. Cefuroxime-based antibiotic prophylaxis is safe in patients undergoing primary elective joint replacement.
在关节置换手术期间通常会使用抗生素预防，这可能使患者易患艰难梭菌相关性疾病（CDAD）。本研究的主要目的是使用基于头孢呋辛的方案确定关节置换术后CDAD的发生率。将发生CDAD的患者与未发生CDAD的对照组患者进行比较。前者的发生率为每1000例初次关节置换中有1.7例。那些额外使用抗生素的患者发生CDAD的发生率更高（p = 0.047），但两组在使用胃保护剂方面没有差异（p = 0.703）。一项新的预防方案试验需要每组43198名患者才能显示每1000例手术中减少一例。基于头孢呋辛的抗生素预防对接受初次择期关节置换的患者是安全的。
