The effect of guideline-based antimicrobial therapy on the outcome of fracture-related infections (EAT FRI Study)
The effect of guideline-based antimicrobial therapy on the outcome of fracture-related infections (EAT FRI Study)
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DOI：
10.1016/j.jinf.2023.01.028
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发表时间：
2023-02-28
影响因子：
28.2
通讯作者：
Wouthuyzen-Bakker, Marjan
中科院分区：
文献类型：
--
作者：
Corrigan, Ruth;Sliepen, Jonathan;Wouthuyzen-Bakker, Marjan
目标：本研究调查了基于指南的抗生素治疗方案对手术治疗乳腺癌相关感染（FRI）患者结局的依从性。方法：在这项国际多中心观察性研究中，纳入了2015年至2019年期间诊断为FRI的患者。根据FRI共识定义定义FRI。所有患者随访至少1年。选择的抗生素治疗方案与FRI共识组发布的指南进行比较，并与结局相关。治疗成功定义为感染根除并保留肢体。结果：共纳入433例FRI患者（平均年龄49.7 ± 16.1岁），主要发生在胫骨（50.6%）和股骨（21.7%）。在107例（24.7%）病例中观察到抗生素方案完全符合已发表的指南。不依从主要是由于偏离推荐剂量，其次是使用替代抗生素而不是推荐的抗生素，或者不正确使用或不使用利福平。不依从性与更差的结果无关：治疗失败是12.1%的依从性与13.2%的非依从性cases（p = 0.87）。结论：我们报告了良好的结果，在治疗FRI，并表明，轻微偏离FRI指南与较差的结果无关。(c)2023年，任作家。由Elsevier Ltd代表英国感染协会出版。这是一个在CC BY许可证下的开放获取文章（http://creativecommons.org/licenses/by/4.0/）
Aim: This study investigated the compliance with a guideline-based antibiotic regimen on the outcome of patients surgically treated for a fracture-related infection (FRI).Method: In this international multicenter observational study, patients were included when diagnosed with an FRI between 2015 and 2019. FRI was defined according to the FRI consensus definition. All pa-tients were followed for at least one year. The chosen antibiotic regimens were compared to the pub-lished guidelines from the FRI Consensus Group and correlated to outcome. Treatment success was de-fined as the eradication of infection with limb preservation. Results: A total of 433 patients (mean age 49.7 +/- 16.1 years) with FRIs of mostly the tibia (50.6%) and femur (21.7%) were included. Full compliance of the antibiotic regime to the published guidelines was observed in 107 (24.7%) cases. Non-compliance was mostly due to deviations from the recommended dosing, followed by the administration of an alternative antibiotic than the one recommended or an in-correct use or non-use of rifampin. Non-compliance was not associated with a worse outcome: treatment failure was 12.1% in compliant versus 13.2% in non-compliant cases ( p = 0.87).Conclusions: We report good outcomes in the treatment of FRI and demonstrated that minor deviations from the FRI guideline are not associated with poorer outcomes.(c) 2023 The Authors. Published by Elsevier Ltd on behalf of The British Infection Association. This is an open access article under the CC BY license ( http://creativecommons.org/licenses/by/4.0/ )