ANTIBIOTIC-PROPHYLAXIS IN NONCARDIAC THORACIC-SURGERY - CEFAZOLIN VERSUS PLACEBO
ANTIBIOTIC-PROPHYLAXIS IN NONCARDIAC THORACIC-SURGERY - CEFAZOLIN VERSUS PLACEBO
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DOI：
10.1016/1010-7940(91)90103-q
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发表时间：
1991-01-01
影响因子：
3.4
通讯作者：
SANCHEZLLORET, J
中科院分区：
文献类型：
--
作者：
AZNAR, R;MATEU, M;SANCHEZLLORET, J
共有127例接受胸外科手术的患者（57例给予安慰剂，70例术前给予1 g头孢唑林单次给药）被纳入一项随机双盲试验。 两组在平均年龄、性别比、术前住院时间、基础疾病、风险因素、手术类型、手术平均持续时间和胸管引流平均持续时间方面相似。 安慰剂组患者伤口感染的相对风险为3.27（范围1.5-11.5; 95%置信区间）。 头孢唑林显著降低（p < 0.01）伤口感染率-头孢唑林组1例（1.5%）vs安慰剂组8例（14%）-但术后胸腔积脓的发生率- 5例（7%）vs 8例（14%）-或医院获得性肺炎的发生率- 3例（4%）vs 5例（9%）。 9例伤口感染中有3例进行了培养，金黄色葡萄球菌或S。3例均分离到表皮细胞。 另外，对13例胸膜腔感染中的6例进行了培养，并对S.金黄色葡萄球菌（1例）或其他微生物（5例）均分离出。 两组的死亡率相似，所有死亡均与感染无关。 没有遇到药物的不良副作用。 总之，在非心脏胸外科手术中，术前单剂量1 g头孢唑林被证明可有效降低伤口感染率。
A total of 127 patients (57 given placebo and 70 given a single preoperative dose of 1 g cefazolin) undergoing thoracic surgery were included in a randomized double-blind trial. The two groups were similar in regard to mean age, sex ratio, in-hospital stay before surgery, underlying disease, risk factors, type of surgery, mean duration of surgical procedure, and mean duration of chest tube drainage. The relative risk of wound infection of the patients from the placebo group was 3.27 (range 1.5-11.5; 95% confidence interval). Cefazolin significantly reduced (p < 0.01) the wound infection rate - 1 case (1.5%) in the cefazolin group versus 8 cases (14%) in the placebo group - but not the incidence of postoperative pleural empyema - 5 (7%) versus 8 cases (14%) - or nosocomial pneumonia - 3 (4%) versus 5 cases (9%). Cultures were made from 3 out of 9 wound infections and Staphylococcus aureus or S. epidermidis was isolated in all 3. In addition, cultures were made from 6 out of 13 pleural cavity infections and S. aureus (1 case) or other microorganisms (5 cases) were isolated in all 6. Mortality was similar in both groups and all deaths unrelated to the infections. No adverse side effects of the drug were encountered. In conclusion, a single preoperative dose of 1 g cefazolin proved to be effective for reducing the wound infection rate in non-cardiac thoracic surgery.