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土耳其常规耳鼻喉科手术中外科抗生素预防的使用情况。

Usage of Surgical Antibiotic Prophylaxis in Routine Otolaryngologic Surgeries in Turkey.

作者信息

Torun Mümtaz Taner

机构信息

Department of Otolaryngology, Bandirma Onyedi Eylul University, School of Medicine, Balıkesir, Turkey.

出版信息

Int Arch Otorhinolaryngol. 2022 Jul 11;27(1):e123-e129. doi: 10.1055/s-0042-1745727. eCollection 2023 Jan.

Abstract

Inappropriate antibiotic use in the world leads to an increase in both health care costs and antibiotic resistance. Surgical antibiotic prophylaxis (SAP) is used by most surgeons, especially in the postoperative period.  The aim of the study is to determine the approach of ear, nose, and throat (ENT) specialists to surgical antibiotic prophylaxis in routine surgeries, and to raise awareness regarding inappropriate antibiotic use.  ENT specialists from all over Turkey participated in the study by filling out a data collecting form. The form consisted of 6 questions and was sent to specialists via email. Routine ENT operations such as adenoidectomy, tonsillectomy, adenotonsillectomy, ventilation tube application, septoplasty, rhinoplasty, septorhinoplasty (noncomplicated), tympanoplasty, and simple mastoidectomy were chosen for the study. Data were analyzed statistically.  The form results of 110 ENT specialists were evaluated. The rate of participants who used and did not use SAP was 77.3% and 22.7%, respectively. The SAP usage rates of septoplasty, rhinoplasty, and septorhinoplasty operations were 84.7%, 81.2%, and 75.3%, respectively. For tympanoplasty and ventilation tube application operations, the rates were 82.4% and 24.7%, respectively. Finallly, the SAP usage rates of adenoidectomy, tonsillectomy, and adenotonsillectomy were 57.6%, 75.3%, and 72.9%, respectively.  Otolaryngological surgeries are often classified as clean or clean-contaminated surgeries. In most studies in the literature, it is reported that SAP use is unnecessary in routine otolaryngological surgery. Providing inservice training, regularly updating the prophylaxis guidelines and sharing these guidelines with surgeons may prevent inappropriate SAP use.

摘要

全球范围内不恰当的抗生素使用导致医疗保健成本增加以及抗生素耐药性增强。大多数外科医生都会使用外科手术抗生素预防(SAP),尤其是在术后阶段。

本研究的目的是确定耳鼻喉(ENT)专科医生在常规手术中进行外科手术抗生素预防的方法,并提高对不恰当抗生素使用的认识。

来自土耳其各地的耳鼻喉专科医生通过填写数据收集表参与了本研究。该表格包含6个问题,并通过电子邮件发送给专科医生。本研究选择了腺样体切除术、扁桃体切除术、腺扁桃体切除术、通气管置入术、鼻中隔成形术、鼻成形术、鼻中隔鼻成形术(非复杂性)、鼓室成形术和单纯乳突切除术等常规耳鼻喉手术。对数据进行了统计分析。

对110名耳鼻喉专科医生的表格结果进行了评估。使用和未使用SAP的参与者比例分别为77.3%和22.7%。鼻中隔成形术、鼻成形术和鼻中隔鼻成形术的SAP使用率分别为84.7%、81.2%和75.3%。对于鼓室成形术和通气管置入术,使用率分别为82.4%和24.7%。最后,腺样体切除术、扁桃体切除术和腺扁桃体切除术的SAP使用率分别为57.6%、75.3%和72.9%。

耳鼻喉科手术通常被归类为清洁或清洁-污染手术。在文献中的大多数研究中,据报道在常规耳鼻喉科手术中无需使用SAP。提供在职培训、定期更新预防指南并与外科医生分享这些指南可能会防止不恰当使用SAP。

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本文引用的文献

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Antibiotic prophylaxis in otolaryngologic surgery.耳鼻喉科手术中的抗生素预防
Int Arch Otorhinolaryngol. 2013 Jan;17(1):85-91. doi: 10.7162/S1809-97772013000100015.

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