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

You also want an ePaper? Increase the reach of your titles

YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.

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!