Alonso-García M, de-la-Morena J M, de-la-Peña E, Martínez-Hurtado J, Lucas W C, Del-Moral-Luque J A, Villar-Del-Campo M C, Gil-de-Miguel A, Rodríguez-Caravaca G
Unidad de Medicina Preventiva, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España; Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, Alcorcón, Madrid, España.
Unidad de Urología, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, España.
Actas Urol Esp (Engl Ed). 2018 Dec;42(10):639-644. doi: 10.1016/j.acuro.2018.04.004. Epub 2018 Jul 7.
To assess compliance with the antibiotic prophylaxis protocol for patients who underwent renal surgery and its effect on the incidence of surgical wound infection.
We performed a prospective cohort study and assessed the overall compliance and each aspect of the antibiotic prophylaxis (start, administration route, antibiotic of choice, duration and dosage) and reported the compliance rates. The qualitative variables were compared with the chi-squared test, and the quantitative variables were compared with Student's t-test. We studied the effect of antibiotic prophylaxis compliance on the incidence of surgical wound infection in renal surgery, with the relative risk.
The study included 266 patients, with an overall compliance rate of 90.6%. The major cause of noncompliance (3.8%) was the start of the prophylaxis, and the incidence rate of surgical wound infections was 3.4%. We found no relationship between antibiotic prophylaxis noncompliance and surgical wound infections (RR=0.26; 95%CI: 0.1-1.2; P>.05). Laparoscopic surgery had a lower incidence of surgical wound infections than open surgery (RR=0.10; 95%CI: 0.01-0.79).
The antibiotic prophylaxis compliance was high. The incidence of surgical site infection was low, and there was no relationship between the incidence of surgical site infection and antibiotic prophylaxis compliance. The incidence of infection was lower in laparoscopic surgery.
评估接受肾脏手术患者对抗生素预防方案的依从性及其对手术伤口感染发生率的影响。
我们进行了一项前瞻性队列研究，评估了抗生素预防的总体依从性以及各个方面（开始时间、给药途径、选择的抗生素、持续时间和剂量），并报告了依从率。定性变量采用卡方检验进行比较，定量变量采用学生t检验进行比较。我们采用相对危险度研究了抗生素预防依从性对肾脏手术中手术伤口感染发生率的影响。
该研究纳入了266例患者，总体依从率为90.6%。不依从的主要原因（3.8%）是预防开始时间，手术伤口感染发生率为3.4%。我们发现抗生素预防不依从与手术伤口感染之间没有关系（RR = 0.26；95%CI：0.1 - 1.2；P >.05）。腹腔镜手术的手术伤口感染发生率低于开放手术（RR = 0.10；95%CI：0.01 - 0.79）。
抗生素预防的依从性较高。手术部位感染的发生率较低，且手术部位感染发生率与抗生素预防依从性之间没有关系。腹腔镜手术的感染发生率较低。
