Antibiotikaprofylax vid kirurgiska ingrepp - SBU
02.01.2015 • Views
Share Embed Flag

Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Antibiotikaprofylax vid kirurgiska ingrepp - SBU

SHOW MORE
SHOW LESS
ePAPER READ
DOWNLOAD ePAPER
sbu.se

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

START NOW

Table 4.8.3 Choice of antibiotics.<br />

Author<br />

Year<br />

Reference<br />

Country<br />

Study<br />

design<br />

Population<br />

characteristics<br />

Intervention<br />

Method<br />

Number indi<strong>vid</strong>uals<br />

Control<br />

Number<br />

indi<strong>vid</strong>uals<br />

Results<br />

Withdrawal<br />

Drop outs<br />

Study quality<br />

and relevance<br />

Comments<br />

Bolon<br />

2004<br />

[25]<br />

Metaanalysis<br />

7 studies<br />

Cardiac surgery (studies<br />

randomised, controlled,<br />

published in english, SSI<br />

primary outcome.<br />

n=5 761<br />

Follow-up 30 days<br />

I: Glycopeptide (teicoplanin<br />

or vancomycin)<br />

C: Beta-lactam agent<br />

(penicillin or cephalosporin)<br />

SSI total<br />

I: 2.6–11.5<br />

C: 5.2–10.3<br />

RR 1.14 (95% CI 0.91–1.42)<br />

SSI chest<br />

RR 1.47 (95% CI 1.11–1.95)<br />

SSI deep chest<br />

RR 1.33 (95% CI 0.91–1.94)<br />

High<br />

SSI leg<br />

RR 0.77 (95% CI 0.58–1.01)<br />

Dhadwal<br />

2007<br />

[26]<br />

United<br />

Kingdom<br />

RCT<br />

Pts undergoing median<br />

sternotomy for coronary<br />

artery bypass grafting,<br />

having one or more of<br />

the following risk factors:<br />

obesity, BMI 30 kg/m 2 ,<br />

diabetes mellitus, or<br />

bilateral internal thoracic<br />

artery grafts (ie, the use<br />

of the other internal<br />

thoracic artery)<br />

Follow-up 90 days<br />

I: Single dose of gentamicin<br />

2 mg/kg, rifampicin 600 mg<br />

and vancomycin 15 mg/kg,<br />

with three further doses<br />

of 7.5 mg/kg at 12-h intervals<br />

(n=87)<br />

C: Cefuroxime<br />

1.5 g at induction<br />

and 3 further<br />

doses of 750 mg at<br />

8-h intervals (n=99)<br />

Sternal wound infection<br />

reduction<br />

I: 8 pts (9.2%),<br />

(95% CI 3.5%–15.3%)<br />

C: 25 pts (25.2%),<br />

(95% CI 19.5%–39.4%)<br />

p=0.004<br />

0 Moderate<br />

Hall<br />

1993<br />

[24]<br />

Australia<br />

RCT<br />

All open heart performed<br />

by sternotomy<br />

I: Ceftriaxone 1 g iv immediately<br />

after anaesthesia<br />

induction<br />

C: Flucloxacillin 2 g<br />

iv immediately after<br />

anaesthesia induction<br />

1 g at start of ECC +<br />

1 g every 4 h for 48 h.<br />

Gentamicin 1.3 mg/kg<br />

iv immediately after<br />

anaesthesia induction<br />

+ every 8 h for 48 h<br />

SSI major sternum<br />

I: 14/515 (2.7%)<br />

C: 8/516 (1.6%)<br />

SSI major limb<br />

I: 16/377 (4.2%)<br />

C: 21/386 (5.4%)<br />

SSI minor sternum<br />

I: 37/515 (7.2%)<br />

C: 41/516 (7.9%)<br />

Several pts<br />

randomised<br />

not undergoing<br />

surgery. Error<br />

rate in administration<br />

3.8%.<br />

19 received<br />

flucloxacillin<br />

+ gentamicin,<br />

7 received<br />

cephalothin<br />

High<br />

Ceftriaxone<br />

were more<br />

likely to have<br />

staphylococci<br />

isolates<br />

SSI minor limb<br />

I: 42/377 (11.1%)<br />

C: 47/386 (12.2%)<br />

The table continues on the next page<br />

376 antibiotikaprofylax <strong>vid</strong> <strong>kirurgiska</strong> <strong>ingrepp</strong> KAPITEL 4 • den systematiska litteraturöversikten<br />

377

logo

products

Resources

Company

Terms of service
Privacy policy
Cookie policy
Cookie settings
Imprint
Change language
Made with love in Switzerland
© 2024 Yumpu.com all rights reserved

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!