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经验性抗菌药物选择与确定性抗菌药物选择对接受全耳道切除术联合外侧鼓泡切开术的犬猫术后并发症的影响:120例病例(2009 - 2019年)

Effect of empirical versus definitive antimicrobial selection on postoperative complications in dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy: 120 cases (2009-2019).

作者信息

Folk Christian A, Lux Cassie N, Sun Xiaocun, Fryer Katy J

机构信息

1Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.

2Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN.

出版信息

J Am Vet Med Assoc. 2022 Mar 24;260(8):899-910. doi: 10.2460/javma.21.10.0462.

Abstract

OBJECTIVE

To evaluate dogs and cats undergoing total ear canal ablation with lateral bulla osteotomy (TECA-LBO), document antimicrobial choices, and determine relationships associated with infection-related and neurologic postoperative complications.

ANIMALS

107 client-owned dogs and 13 client-owned cats that underwent TECA-LBO.

PROCEDURES

A retrospective analysis of medicals records of dogs and cats with TECA-LBO from 2 veterinary hospitals with postoperative data for at least 6 months was performed. All information associated with the TECA-LBO surgery including follow-up was recorded. Logistic regression analyses were performed and corrected using a false discovery rate to identify significance between antimicrobial administration and other perioperative variables and the outcomes of short- and long-term neurologic and infection-related complications, need for revision surgery, and euthanasia due to recurrence of infection-related signs.

RESULTS

Intraoperative cultures were performed in 111 animals, and 95 (85.5%) had bacterial growth, with Staphylococcus spp most commonly isolated. Revision surgeries due to infection-related signs occurred in 13 of 120 (10.8%) patients. If intraoperative bacterial cultures were positive and antimicrobials were administered within 1 month of surgery, patients were 85.8% less likely to exhibit infection-related complications, whereas patients not administered antimicrobials were 10.3 times as likely to require a revision surgery. Longer durations of postoperative antimicrobial administration were associated with revision surgery and euthanasia due to infection-related signs.

CLINICAL RELEVANCE

Administration of systemic antimicrobials within the first postoperative month may be necessary to prevent complications when intraoperative cultures exhibit bacterial growth and plays a role in the successful outcome of TECA-LBO.

摘要

目的

评估接受全耳道切除联合外侧鼓泡切开术(TECA-LBO)的犬猫,记录抗菌药物的选择,并确定与感染相关和神经学术后并发症相关的因素。

动物

107只客户拥有的犬和13只客户拥有的猫接受了TECA-LBO。

程序

对来自2家兽医医院的接受TECA-LBO的犬猫病历进行回顾性分析,这些病历具有至少6个月的术后数据。记录与TECA-LBO手术相关的所有信息,包括随访情况。进行逻辑回归分析,并使用错误发现率进行校正,以确定抗菌药物给药与其他围手术期变量以及短期和长期神经学及感染相关并发症的结果、翻修手术需求以及因感染相关体征复发导致的安乐死之间的显著性。

结果

111只动物进行了术中培养,95只(85.5%)有细菌生长,最常分离出葡萄球菌属。120例患者中有13例(10.8%)因感染相关体征进行了翻修手术。如果术中细菌培养呈阳性且在手术后1个月内给予抗菌药物,患者出现感染相关并发症的可能性降低85.8%,而未给予抗菌药物的患者需要翻修手术的可能性是前者的10.3倍。术后抗菌药物给药时间延长与因感染相关体征进行翻修手术和安乐死有关。

临床意义

当术中培养显示细菌生长时,术后第一个月内给予全身抗菌药物对于预防并发症可能是必要的,并且在TECA-LBO的成功结果中发挥作用。

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