Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario N1G 2W1.
Can J Vet Res. 2024 Jan;88(1):24-29.
Antimicrobial stewardship has shown significant development in recent years. Perioperative prophylaxis accounts for a substantial volume of antimicrobial use and is a field in which improvements can likely be made. The objective of this study was to evaluate practices associated with perioperative antimicrobial use in equine elective laparoscopy at a single institution over a 21-year period and to determine whether antimicrobial therapy influenced the occurrence of postoperative complications. Medical records of horses that underwent elective laparoscopy at a teaching hospital from January 2000 to September 2021 were reviewed. Data obtained included signalment, surgeon, type and duration of procedure, perioperative antimicrobial use, and intraoperative and postoperative complications. Exact univariate logistic regression was used to explore the association between possible risk factors and occurrence of postoperative complications, as well as the association between year of presentation and time of antimicrobial administration. Duration of surgery was log-transformed to meet assumption of normality, followed by analysis of variance (ANOVA) to compare mean surgery time per procedure and postoperative complications. Significance was set at < 0.05. Sixty horses met the inclusion criteria. All horses received antimicrobial prophylaxis, but none received intraoperative redosing. Only 13 horses (26%) received antimicrobials within 60 min of the first incision. Time of administration improved with each year of the study ( = 0.005). Only 17 horses (28%) received antimicrobials for less than 24 h, but median duration of antimicrobial therapy was 1.25 d (range: 0.25 to 10 d). Antimicrobial use practices at this institution differed from general recommendations for optimal perioperative prophylaxis, which suggests that intervention is required.
近年来,抗菌药物管理取得了显著进展。围手术期预防用药占抗菌药物用量的很大一部分,是一个可以改进的领域。本研究的目的是评估一家机构 21 年来马属动物择期腹腔镜手术中围手术期抗菌药物使用的情况,并确定抗菌治疗是否会影响术后并发症的发生。对 2000 年 1 月至 2021 年 9 月在一家教学医院接受择期腹腔镜手术的马的病历进行了回顾。获得的数据包括年龄、手术医生、手术类型和持续时间、围手术期抗菌药物使用情况以及术中术后并发症。使用精确的单变量逻辑回归来探讨可能的危险因素与术后并发症发生之间的关系,以及呈现年份与抗菌药物使用时间之间的关系。为满足正态性假设,对手术时间进行对数转换,然后进行方差分析(ANOVA)比较每例手术的平均手术时间和术后并发症。显著性水平设定为 < 0.05。60 匹马符合纳入标准。所有马匹均接受了抗菌预防用药,但术中未追加剂量。只有 13 匹马(26%)在第一次切开后 60 分钟内使用了抗菌药物。随着研究年份的增加,用药时间有所改善( = 0.005)。只有 17 匹马(28%)使用抗菌药物的时间不足 24 小时,但抗菌药物治疗的中位持续时间为 1.25 天(范围:0.25 至 10 天)。该机构的抗菌药物使用实践与最佳围手术期预防用药的一般建议不同,这表明需要进行干预。