Stone H H, Hooper C A, Kolb L D, Geheber C E, Dawkins E J
Ann Surg. 1976 Oct;184(4):443-52. doi: 10.1097/00000658-197610000-00007.
Antibiotic prophylaxis for surgery has appeared indicated whenever likelihood of infection is great or consequences of such are catastrophic. For better clarification, a prospective, randomized, double-blind study was run on 400 patients undergoing elective gastric, biliary, and colonic operations. There were four treatment categories, with antibiotic being instituted 12 hours preoperatively, just prior to operation, after operation, or not at all. During operation, samples of blood, viscera, muscle, and fat were taken for determination of antibiotic concentration. Both aerobic and anareobic cultures were also taken of any viscus entered, peritoneal cavity, and incision. Similar cultures were run on all postoperative infections. Results demonstrated that the incidence of wound infection could be reduced significantly by the preoperative administration of antibiotic in operations on the stomach (22% to 4%), on the biliary tract (11% to 2%), and large bowel (16% to 6%). Less impressive results were obtained for peritoneal sepsis. Initiation of antibiotic postoperatively gave an almost identical infection rate as if antibiotic had not been given (15% and 16%, respectively).
只要感染可能性很大或感染后果极为严重，就似乎有必要进行手术预防性使用抗生素。为了更清楚地说明这一点，对400例行择期胃、胆道和结肠手术的患者进行了一项前瞻性、随机、双盲研究。有四个治疗组，抗生素分别在术前12小时、手术即将开始时、术后或根本不使用。手术期间，采集血液、内脏、肌肉和脂肪样本以测定抗生素浓度。对进入的任何脏器、腹腔和切口进行需氧和厌氧培养。对所有术后感染也进行类似培养。结果表明，在胃手术（从22%降至4%）、胆道手术（从11%降至2%）和大肠手术（从16%降至6%）中，术前使用抗生素可显著降低伤口感染发生率。对于腹膜败血症，效果不太明显。术后开始使用抗生素的感染率几乎与未使用抗生素时相同（分别为15%和16%）。
