Uchida Kazutaka, Takahama Keita, Higashi Kenshiro, Kusano Yuki, Matsumoto Koki, Nakagawa Yoshihiro, Oda Kazutaka
Department of Pharmacy, Kumamoto Shinto General Hospital, 3-2-65, Oe, Chuo-ku, Kumamoto city, Kumamoto, 862-8655, Japan.
Department of Ophthalmology, Kumamoto Shinto General Hospital, 3-2-65, Oe, Chuo-ku, Kumamoto city, Kumamoto, 862-8655, Japan.
J Pharm Health Care Sci. 2025 Jan 30;11(1):9. doi: 10.1186/s40780-025-00412-x.
Cataract surgeries are increasing annually, making appropriate medical management essential. The routine use of systemic antimicrobial agents for preventing surgical site infections lacks strong evidence and may increase the risk of drug-resistant bacteria and adverse events. This study examined the impact of discontinuing cefazolin (CEZ) administration during the perioperative period of cataract surgery on the incidence of postoperative adverse events and medical costs.
Inpatient cataract surgery patients were divided into two groups: the CEZ-use group (April 2021 to March 2022) and the non-CEZ-use group (April 2022 to March 2023). The primary endpoints were the incidence of adverse events and medical costs, while the secondary endpoint was the incidence of endophthalmitis.
A total of 265 patients were in the CEZ group, and 316 were in the non-CEZ group. Six postoperative adverse events (2.3%, 95% confidence interval: 0.8-4.9) occurred in the CEZ group, with an estimated 230 patients (80-490 from the 95% confidence interval) expected to experience adverse events per 10,000 patients using CEZ. The non-CEZ group had no adverse events and reduced drug costs by approximately 46,000 yen. Insurance claim amounts were also reduced. No cases of early postoperative endophthalmitis were observed in either group.
Discontinuation of CEZ prophylaxis during the perioperative period of cataract surgery effectively reduced the risk of adverse events. Medical for the period after discontinuing CEZ did not increase.
Retrospectively registered.
白内障手术数量逐年增加，因此恰当的医疗管理至关重要。常规使用全身性抗菌药物预防手术部位感染缺乏有力证据，且可能增加耐药菌及不良事件的风险。本研究探讨了白内障手术围手术期停用头孢唑林（CEZ）对术后不良事件发生率及医疗费用的影响。
将住院白内障手术患者分为两组：CEZ使用组（2021年4月至2022年3月）和非CEZ使用组（2022年4月至2023年3月）。主要终点为不良事件发生率及医疗费用，次要终点为眼内炎发生率。
CEZ组共有265例患者，非CEZ组有316例患者。CEZ组发生6例术后不良事件（2.3%，95%置信区间：0.8 - 4.9），估计每10,000例使用CEZ的患者中有230例（95%置信区间为80 - 490例）会发生不良事件。非CEZ组未发生不良事件，药物费用降低了约46,000日元。保险理赔金额也有所减少。两组均未观察到早期术后眼内炎病例。
白内障手术围手术期停用CEZ预防措施可有效降低不良事件风险。停用CEZ后的医疗费用并未增加。
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