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妇科手术中抗生素预防的外科医生实践模式。

Surgeon practice patterns for antibiotic prophylaxis in gynecologic surgery.

作者信息

Schimpf Megan O, Morrill Michelle Y, Margulies Rebecca U, Ward Renée M, Carberry Cassandra L, Sung Vivian W

机构信息

Division of Urogynecology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI 48109, USA.

出版信息

Female Pelvic Med Reconstr Surg. 2012 Sep-Oct;18(5):281-5. doi: 10.1097/SPV.0b013e31826446ba.

Abstract

OBJECTIVE

To assess surgeon practice patterns for antibiotic prophylaxis in gynecologic surgery.

METHODS

A survey was distributed at the 2011 annual scientific meeting of the Society of Gynecologic Surgeons regarding antibiotic prophylaxis practices.

RESULTS

The response rate was 51%. Most surgeons did not use antibiotic prophylaxis for dilation and curettage without products of conception, hysteroscopy, and loop electrocautery excision procedure/cone biopsy. For laparoscopy without graft placement, 45.9% did not use prophylaxis. Prophylaxis was common for hysterectomy. For midurethral slings, 8.2% did not use prophylaxis. When graft material was used in prolapse surgery, at least 93% of surgeons administered some form of antibiotic prophylaxis. Only 70% of respondents prescribe antibiotic prophylaxis for hysterectomy consistent with recommendations from the American College of Obstetricians and Gynecologists, whereas 78% are consistent with specifications from the Joint Commission.

CONCLUSIONS

Wide variability exists in antibiotic prophylaxis in gynecologic surgery. Surgeon preference or local hospital policies affect choice of prophylaxis less than 14.9% of the time.

摘要

目的

评估妇科手术中外科医生预防性使用抗生素的实践模式。

方法

在2011年妇科外科医生协会年度科学会议上分发了一份关于预防性使用抗生素实践的调查问卷。

结果

回复率为51%。大多数外科医生在无妊娠产物的刮宫术、宫腔镜检查以及环形电切术/锥形活检时不使用预防性抗生素。对于未放置移植物的腹腔镜手术,45.9%的医生不使用预防性抗生素。子宫切除术时预防性使用抗生素很常见。对于经尿道中段吊带术,8.2%的医生不使用预防性抗生素。在脱垂手术中使用移植物材料时,至少93%的外科医生会给予某种形式的预防性抗生素。只有70%的受访者按照美国妇产科医师学会的建议为子宫切除术开具预防性抗生素,而78%的受访者符合联合委员会的规范。

结论

妇科手术中预防性使用抗生素的情况存在很大差异。外科医生的偏好或当地医院政策对预防性用药选择的影响不到14.9%。

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