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[直肠手术中抗生素预防性应用的充分性评估]

[Assessment of antibiotic prophylaxis adequacy in rectal surgery].

作者信息

Del-Moral-Luque J A, Colás-Ruiz E, Gil-Yonte P, Fernández-Cebrián J M, Villar-Del-Campo M C, Delgado-Iribarren A, Valverde-Cánovas J F, Rodríguez-Caravaca G

机构信息

Gil Rodríguez Caravaca, Unidad de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, C/ Budapest 1, 28922 Alcorcón (Madrid) Spain.

出版信息

Rev Esp Quimioter. 2017 Feb;30(1):14-18. Epub 2016 Dec 23.

Abstract

OBJECTIVE

Antibiotic prophylaxis is the most suitable tool for preventing surgical site infection (SSI), so the development of guidelines and assessment of its monitoring is essential. In this study protocol compliance of antibiotic prophylaxis in rectal surgery and the effect of its adequacy in terms of pre-ention of SSI was assessed.

METHODS

Prospective cohort study was conducted from 1 January 2009 to 30 December 2015. The degree of compliance with antibiotic prophylaxis and causes of non-compliance in rectal surgery was evaluated. The incidence of SSI was studied after a maximum period of 30 days of incubation. To assess the effect of prophylaxis non-compliance on SSI the relative risk (RR) adjusted with the aid of a logistic regression model was used.

RESULTS

The study covered a total of 244 patients. The patients infected reached 20 cases with a SSI cumulative incidence of 8.2% (CI95%: 4.8-11.6). Antibiotic prophylaxis was indicated in all patients and was administered in 98% of cases, with an overall protocol compliance 92.5%. The principal cause of non-compliance was the choice of antibiotic 55.6% (n=10). The effect of inadequacy of antibiotic prophylaxis on surgical infection was RR=0.58, CI95%: 0.10-4.10 (P>0.05).

CONCLUSIONS

Compliance with antibiotic prophylaxis was high. No relationship between the adequacy of prophylaxis and incidence of surgical site infection in rectal surgery was found.

摘要

目的

抗生素预防是预防手术部位感染(SSI)最合适的手段,因此制定指南并评估其监测至关重要。本研究评估了直肠手术中抗生素预防的方案依从性及其在预防SSI方面的充分性效果。

方法

于2009年1月1日至2015年12月31日进行前瞻性队列研究。评估直肠手术中抗生素预防的依从程度及不依从的原因。在最长30天的潜伏期后研究SSI的发生率。为评估预防不依从对SSI的影响,使用了借助逻辑回归模型调整的相对风险(RR)。

结果

该研究共纳入244例患者。感染患者达20例,SSI累积发生率为8.2%(95%CI:4.8 - 11.6)。所有患者均有抗生素预防指征,98%的病例使用了抗生素,总体方案依从率为92.5%。不依从的主要原因是抗生素选择,占55.6%(n = 10)。抗生素预防不足对手术感染的影响为RR = 0.58,95%CI:0.10 - 4.10(P>0.05)。

结论

抗生素预防的依从性较高。未发现直肠手术中预防的充分性与手术部位感染发生率之间存在关联。

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