Lee Michael R, Paver Robert
Skin and Cancer Foundation, Sydney, New South Wales, Australia.
Australas J Dermatol. 2016 May;57(2):83-91. doi: 10.1111/ajd.12312. Epub 2015 Mar 5.
This is a review of the common pathogens of surgical site infections, antibiotic coverage for particular anatomical sites, mechanisms by which surgical site infections occur and the latest data and recommendations for prophylactic antibiotics in the prevention of surgical site infections, infective endocarditis and haematogenous joint infections. Recent evidence-based guidelines on surgical prophylaxis is for restricted indications and a shorter duration of antibiotic prophylaxis in situations where no clinical benefit of prolonged therapy has been proven, in order to minimise the potential adverse ecological and clinical effects associated with antibiotic therapy. This review recommends the cautious use of prophylactic antibiotics in dermatological surgery to help prevent the growing problem of bacterial resistance as well as other morbidity and health-care costs.
本文综述了手术部位感染的常见病原体、特定解剖部位的抗生素覆盖范围、手术部位感染的发生机制以及预防手术部位感染、感染性心内膜炎和血源性关节感染的预防性抗生素的最新数据和建议。近期基于循证医学的手术预防指南指出，预防性抗生素的使用指征应严格限制，在未证实延长治疗有临床益处的情况下，抗生素预防的持续时间应缩短，以尽量减少与抗生素治疗相关的潜在不良生态和临床影响。本综述建议在皮肤科手术中谨慎使用预防性抗生素，以帮助预防日益严重的细菌耐药性问题以及其他发病率和医疗保健费用。
