Rodgers K G
F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
Emerg Med Clin North Am. 1994 Aug;12(3):863-81.
The incidence of prosthetic infections presenting to the emergency department is constantly increasing as the number of patients with prostheses grows. Our first duty as emergency physicians is to maintain a high index of suspicion for prosthetic infection in patients presenting with prosthetic dysfunction or fever. Optimal cultures must be obtained before instituting antimicrobial therapy. In stable patients, this may preclude starting antibiotics in the emergency department. The diversity of prosthetic infections and the need for accurate treatment in order to reduce the morbidity, mortality, and economic costs requires an in-depth knowledge of the microbiology and pharmacologic management of such infections. Except in the case of prosthetic heart valves, prophylactic antibiotics are rarely indicated and their use should be based on judicious clinical decision making.
随着接受假体植入的患者数量增加，前往急诊科就诊的假体感染发生率持续上升。作为急诊医生，我们的首要职责是对出现假体功能障碍或发热的患者保持高度的假体感染怀疑指数。在开始抗菌治疗之前，必须获取最佳的培养样本。对于病情稳定的患者，这可能意味着不在急诊科开始使用抗生素。假体感染的多样性以及为降低发病率、死亡率和经济成本而进行准确治疗的必要性，需要深入了解此类感染的微生物学和药物治疗管理。除了人工心脏瓣膜的情况外，预防性使用抗生素很少有必要，其使用应基于明智的临床决策。
