犬咬伤伤口的预防性苯唑西林治疗。

Prophylactic oxacillin in dog bite wounds.

作者信息

Elenbaas R M, McNabney W K, Robinson W A

出版信息

Ann Emerg Med. 1982 May;11(5):248-51. doi: 10.1016/s0196-0644(82)80093-0.

Abstract

This prospective, double-blind, placebo-controlled study was undertaken to determine the value of prophylactic oxacillin in dog bites. Adult patients with uninfected full-thickness wounds presenting within 24 hours of injury were considered. Management consisted of cleansing, irrigation, debridement, and closure as indicated; no topical antibiotics were applied. Patients were randomly assigned to receive oxacillin 500 mg QID x 5 days or identically appearing placebo. Home wound care was standardized an patients were observed at least every 2 days. Clinical assessment of infection was confirmed microbiologically. Sixty-three patients were admitted and 46 completed the study. Oxacillin (22) and placebo (24) groups were identical in sex, age, number of wounds per patient, wound location and type, number of open and closed wounds, delay to presentation, length of follow-up observation, medication compliance, and adequacy of patient wound care. Two infections of the hand occurred in patients receiving oxacillin; no infections were seen among placebo-treated patients (P = NS). Prophylactic oxacillin was not associated with improved outcome. We do not advise the use of prophylactic antibiotics in dog bite injuries treated within 24 hours of accident.

摘要

本前瞻性、双盲、安慰剂对照研究旨在确定预防性使用苯唑西林在犬咬伤中的价值。研究纳入了受伤后24小时内出现未感染全层伤口的成年患者。治疗措施包括按需要进行清洁、冲洗、清创和缝合；未应用局部抗生素。患者被随机分配接受500毫克苯唑西林，每日四次，共5天，或外观相同的安慰剂。家庭伤口护理标准化，患者至少每2天接受观察。感染的临床评估通过微生物学方法确认。63例患者入院，46例完成研究。苯唑西林组（22例）和安慰剂组（24例）在性别、年龄、每位患者的伤口数量、伤口位置和类型、开放和闭合伤口的数量、就诊延迟时间、随访观察时长、药物依从性以及患者伤口护理的充分性方面均相同。接受苯唑西林治疗的患者中有2例手部感染；安慰剂治疗的患者中未出现感染（P = 无显著差异）。预防性使用苯唑西林并未带来更好的治疗效果。对于在事故发生后24小时内治疗的犬咬伤，我们不建议使用预防性抗生素。