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接受牙科、颌面或耳鼻喉(ENT)手术的新生儿和儿童的抗菌药物预防:一项兰德/加州大学洛杉矶分校适宜性方法共识研究。

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study.

作者信息

Rigotti Erika, Bianchini Sonia, Nicoletti Laura, Monaco Sara, Carrara Elena, Opri Francesca, Opri Roberta, Caminiti Caterina, Donà Daniele, Giuffré Mario, Inserra Alessandro, Lancella Laura, Mugelli Alessandro, Piacentini Giorgio, Principi Nicola, Tesoro Simonetta, Venturini Elisabetta, Staiano Annamaria, Villani Alberto, Sesenna Enrico, Vicini Claudio, Esposito Susanna

机构信息

Pediatric Unit, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, 37124 Verona, Italy.

Pediatric Clinic, University Hospital, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy.

出版信息

Antibiotics (Basel). 2022 Mar 13;11(3):382. doi: 10.3390/antibiotics11030382.

Abstract

Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days−18 years) undergoing dental, maxillo-facial or ENT surgical procedures. These included: (1) dental surgery; (2) maxilla-facial surgery following trauma with fracture; (3) temporo-mandibular surgery; (4) cleft palate and cleft lip repair; (5) ear surgery; (6) endoscopic paranasal cavity surgery and septoplasty; (7) clean head and neck surgery; (8) clean/contaminated head and neck surgery and (9) tonsillectomy and adenoidectomy. Due to the lack of pediatric data for the majority of dental, maxillo-facial and ENT surgeries and the fact that the recommendations for adults are currently used, there is a need for ad hoc studies to be rapidly planned for the most deficient areas. This seems even more urgent for interventions such as those involving the first airways since the different composition of the respiratory microbiota in children compared to adults implies the possibility that surgical antibiotic prophylaxis schemes that are ideal for adults may not be equally effective in children.

摘要

手术部位感染(SSIs)是手术过程中潜在的并发症,主要是因为清洁/污染手术涉及通常被细菌定植的器官。牙科、颌面和耳鼻喉(ENT)手术属于有SSIs风险的手术,因为口腔和上呼吸道通常被细菌菌群定植。本共识文件的目的是为临床医生提供有关接受牙科、颌面或耳鼻喉外科手术的新生儿(实际年龄<28天)和儿科患者(年龄在29天至18岁之间)手术抗菌预防的建议。这些手术包括:(1)牙科手术;(2)创伤后伴有骨折的颌面手术;(3)颞下颌手术;(4)腭裂和唇裂修复;(5)耳部手术;(6)鼻内镜鼻窦手术和鼻中隔成形术;(7)清洁的头颈手术;(8)清洁/污染的头颈手术;以及(9)扁桃体切除术和腺样体切除术。由于大多数牙科、颌面和耳鼻喉手术缺乏儿科数据,且目前使用的是成人的建议,因此需要迅速针对最缺乏数据的领域开展专门研究。对于涉及上呼吸道的干预措施来说,这似乎更为紧迫,因为与成人相比,儿童呼吸道微生物群的组成不同,这意味着对成人理想的手术抗生素预防方案在儿童中可能不会同样有效。

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