抗生素类型而非预防持续时间与骨折相关感染率相关。
Type of antibiotic but not the duration of prophylaxis correlates with rates of fracture-related infection.
机构信息
Department of Orthopedic and Traumatology, Escola Paulista de Medicina, Federal University of São Paulo,- UNIFESP, Rua Botucatu 740, Vila Clementino, São Paulo, 04023062, Brazil.
Department of Internal Medicine, Division of Infectious Diseases, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil.
出版信息
Eur J Orthop Surg Traumatol. 2023 May;33(4):987-992. doi: 10.1007/s00590-022-03246-7. Epub 2022 Mar 9.
PURPOSE
The issue of optimal prophylactic antibiotic administration for closed and open fracture surgeries remains controversial. The purpose of this study was to assess the role of type and duration longer than 48 h of antibiotic prophylaxis on the rates of fracture-related infection (FRI).
METHODS
This is a single-center, prospective observational cohort study carried out with patients undergoing surgery for implants insertion to fracture stability. Risk estimates were calculated on the variables associated with factors for FRI and reported as a prevalence ratio (PR) with respect to the 95% confidence interval (CI).
RESULTS
Overall, 132 patients were analyzed. The global rate of FRI was 15.9% (21/132), with open and closed fractures accounting for 30.5% (11/36) and 10.4% (10/96), respectively. The FRI rates in patients undergoing orthopedic surgery for fracture stabilization who received prophylactic antibiotic for up to and longer than 48 h were 8.9% and 26.4%, respectively. This difference did not reach statistical significance (prevalence ratio [PR] = 2.6, 95% confidence interval [95% CI]: 0.9-7.3. p = 0.063).
CONCLUSIONS
Duration of antibiotic prophylaxis for surgical orthopedic fractures was not correlated with rates of FRI.
目的
对于闭合性和开放性骨折手术的最佳预防性抗生素使用问题仍存在争议。本研究旨在评估抗生素预防的类型和持续时间超过 48 小时对骨折相关感染（FRI）发生率的影响。
方法
这是一项在接受植入物插入以稳定骨折的患者中进行的单中心前瞻性观察队列研究。对与 FRI 相关因素的变量进行风险估计，并以患病率比（PR）及其 95%置信区间（95%CI）报告。
结果
总共分析了 132 名患者。FRI 的总体发生率为 15.9%（21/132），其中开放性和闭合性骨折分别占 30.5%（11/36）和 10.4%（10/96）。接受骨科手术治疗骨折稳定的患者中，预防性抗生素使用时间长达 48 小时或更长时间的 FRI 发生率分别为 8.9%和 26.4%。差异无统计学意义（患病率比 [PR] = 2.6，95%置信区间 [95%CI]：0.9-7.3，p = 0.063）。
结论
骨科骨折手术预防性抗生素的持续时间与 FRI 发生率无关。
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