Kreutzer Kilian, Storck Katharina, Weitz Jochen
Department of Oral and Maxillofacial Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany.
Department of Otorhinolaryngology Head and Neck Surgery, Technische Universität München, Klinikum rechts der Isar, Ismaninger Straße 22, 81675 Munich, Germany.
Biomed Res Int. 2014;2014:879437. doi: 10.1155/2014/879437. Epub 2014 Jul 8.
Antibiotic prophylaxis is commonly used to decrease the rate of infections in head and neck surgery. The aim of this paper is to present the available evidence regarding the application of antibiotic prophylaxis in surgical procedures of the head and neck region in healthy patients. A systemic literature review based on Medline and Embase databases was performed. All reviews and meta-analyses based on RCTs in English from 2000 to 2013 were included. Eight out of 532 studies fulfilled all requirements. Within those, only seven different operative procedures were analyzed. Evidence exists for the beneficial use of prophylactic antibiotics for tympanostomy, orthognathic surgery, and operative tooth extractions. Unfortunately, little high-level evidence exists regarding the use of prophylactic antibiotics in head and neck surgery. In numerous cases, no clear benefit of antibiotic prophylaxis has been shown, particularly considering their potential adverse side effects. Antibiotics are often given unnecessarily and are administered too late and for too long. Furthermore, little research has been performed on the large number of routine cases in the above-mentioned areas of specialization within the last few years, although questions arising with respect to the treatment of high-risk patients or of specific infections are discussed on a broad base.
抗生素预防性用药常用于降低头颈外科手术的感染率。本文旨在阐述关于在健康患者的头颈区域外科手术中应用抗生素预防性用药的现有证据。基于Medline和Embase数据库进行了一项系统性文献综述。纳入了2000年至2013年期间所有基于英文随机对照试验的综述和荟萃分析。532项研究中有8项符合所有要求。在这些研究中，仅分析了7种不同的手术操作。有证据表明预防性抗生素用于鼓膜造孔术、正颌手术和拔牙手术有益。不幸的是，关于头颈外科手术中预防性抗生素的使用，几乎没有高级别证据。在许多情况下，未显示出抗生素预防性用药有明显益处，尤其考虑到其潜在的不良副作用。抗生素常常不必要地使用，给药过晚且时间过长。此外，尽管在广泛基础上讨论了高危患者或特定感染治疗方面出现的问题，但在过去几年中，针对上述专业领域大量常规病例的研究很少。
