Department of Women's and Children's Health, Division of Obstetrics, Department of Pelvic Cancer, Theme Cancer, Karolinska Institutet and Gynecology, Karolinska University Hospital, Eugeniavägen 3, A5:01, Mottagning Gynekologisk Cancer, 171 76, Stockholm, Sweden.
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet and the Division of Obstetrics and Gynecology at Södersjukhuset, Stockholm, Sweden.
Int Urogynecol J. 2023 Nov;34(11):2791-2797. doi: 10.1007/s00192-023-05617-y. Epub 2023 Aug 8.
The aim of this study was to explore if antibiotic prophylaxis prevents postoperative infection after a posterior colporrhaphy.
In this register-based nationwide cohort study data were collected from the "The Swedish National Quality Register of Gynecological Surgery" (GynOp). Women 18 years or older who underwent a primary posterior colporrhaphy between 1 January 2015 and 31 December 2020 were included. Patients undergoing any concomitant prolapse procedure, mesh surgery, or incontinence procedure were excluded. The cohort was divided into two groups based on administration of antibiotic prophylaxis (n = 1,218) or not (n = 4,884). The primary outcome of this study was patient-reported infectious complication requiring antibiotic treatment. Secondary outcome measures included patient satisfaction and prolapse-related symptoms at 1 year postoperatively.
A total of 7,799 patients who underwent posterior colporrhaphy and met the inclusion criteria and did not meet the exclusion criteria were identified in the register database. Of these patients 6,102 answered the primary outcome question (79%). In the antibiotic prophylaxis group a total of 138 reported a postoperative infection (11%) and in the no antibiotic prophylaxis group the corresponding data were 520 (11%). There were no significant differences regarding either the primary or the secondary outcomes between the study groups.
In this nationwide Swedish register study antibiotic prophylaxis was not associated with a reduced risk of postoperative infection after a posterior colporrhaphy.
本研究旨在探讨抗生素预防用药是否能预防阴道后穹隆修补术后感染。
这是一项基于注册的全国性队列研究，数据来自“瑞典妇科手术质量登记处”（GynOp）。纳入 2015 年 1 月 1 日至 2020 年 12 月 31 日期间接受初次阴道后穹隆修补术的 18 岁及以上女性。排除同期行任何阴道膨出手术、网片手术或尿失禁手术的患者。根据是否给予抗生素预防用药（n=1218）或未给予（n=4884）将患者分为两组。本研究的主要结局为患者报告的需要抗生素治疗的感染性并发症。次要结局指标包括术后 1 年时的患者满意度和与脱垂相关的症状。
在登记数据库中，共识别出 7799 名符合纳入标准且无排除标准的接受阴道后穹隆修补术的患者。其中 6102 名患者回答了主要结局问题（79%）。在抗生素预防用药组中，共有 138 例报告术后感染（11%），而在未使用抗生素预防用药组中，相应数据为 520 例（11%）。两组在主要结局或次要结局方面均无显著差异。
在这项全国性的瑞典登记研究中，阴道后穹隆修补术后使用抗生素预防用药与降低术后感染风险无关。
