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第247号——产科手术中的抗生素预防

No. 247-Antibiotic Prophylaxis in Obstetric Procedures.

作者信息

van Schalkwyk Julie, Van Eyk Nancy

机构信息

Vancouver, BC.

Halifax, NS.

出版信息

J Obstet Gynaecol Can. 2017 Sep;39(9):e293-e299. doi: 10.1016/j.jogc.2017.06.007.

Abstract

OBJECTIVE

To review the evidence and provide recommendations on antibiotic prophylaxis for obstetrical procedures.

OUTCOMES

Outcomes evaluated include need and effectiveness of antibiotics to prevent infections in obstetrical procedures.

EVIDENCE

Published literature was retrieved through searches of Medline and The Cochrane Library on the topic of antibiotic prophylaxis in obstetrical procedures. Results were restricted to systematic reviews, randomized controlled trials/controlled clinical trials, and observational studies. Searches were updated on a regular basis and articles published from January 1978 to June2009 were incorporated in the guideline. Current guidelines published by the American College of Obstetrics and Gynecology were also incorporated. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.

VALUES

The evidence obtained was reviewed and evaluated by the Infectious Diseases Committee of the Society of Obstetricians and Gynaecologists of Canada under the leadership of the principal authors, and recommendations were made according to guidelines developed by the Canadian Task Force on Preventive Health Care (Table 1).

BENEFITS, HARMS, AND COSTS: Implementation of this guideline should reduce the cost and harm resulting from the administration of antibiotics when they are not required and the harm resulting from failure to administer antibiotics when they would be beneficial.

SUMMARY STATEMENTS

RECOMMENDATIONS.

摘要

目的

回顾相关证据并就产科手术的抗生素预防应用提供建议。

结果

评估的结果包括抗生素预防产科手术感染的必要性和有效性。

证据

通过检索Medline和Cochrane图书馆获取有关产科手术抗生素预防应用的已发表文献。结果限于系统评价、随机对照试验/对照临床试验及观察性研究。检索定期更新,纳入了1978年1月至2009年6月发表的文章。美国妇产科医师学会发布的现行指南也被纳入。通过搜索卫生技术评估及与卫生技术评估相关机构的网站、临床实践指南汇编、临床试验注册库以及国家和国际医学专业学会,识别出灰色(未发表)文献。

价值观

在主要作者的领导下,加拿大妇产科学会传染病委员会对获取的证据进行了审查和评估,并根据加拿大预防性医疗保健特别工作组制定的指南提出了建议(表1)。

益处、危害和成本:实施本指南应能降低在无需使用抗生素时使用抗生素带来的成本和危害,以及在使用抗生素有益时未使用抗生素带来的危害。

总结声明

建议。

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