Summary
The use of prophylactic antibiotics was studied prospectively in 2371 consecutive clean orthopedic operations. The infection rates for operations with obvious selection for antibiotic prophylaxis were twice as high (7.2%) as compared with operations with planned prophylaxis (3.4%) and with operations without such prophylaxis (3.7%).
Sixteen per cent of all clean operations received antibiotics for prophylaxis and 85 per cent of all prophylactic courses lasted at least 8 days or longer. Fifty-one per cent of all antimicrobial drugs used during the study were administered for prophylaxis in clean orthopaedic operations. The length of the hospital stay was the only factor closely related to the length of antibiotic prophylaxis.
The drugs most often used for prophylaxis were penicillinaseresistent penicillins. Significant increase of gram-negative pathogens was observed in cultures from wounds of patients on antibiotic prophylaxis.
Zusammenfassung
Wir untersuchten die Anwendung der prophylaktischen Antibiotika in einem lückenlosen klinischen Krankengut, bestehend aus 2371 reinen orthopädischen Operationen. Die Untersuchung war im voraus geplant.
Die Infektionshäufigkeit für die Operationen mit deutlicher Auswahl für die antibiotische Prophylaxe war zweimal so hoch (7,2%) im Vergleich zu Operationen mit plangemäßer antibiotischer Prophylaxe (3,4%) und zu Operationen ohne antibiotischen Schutz (3,7%).
In 16% von alien reinen Operationen wurde die antibiotische Prophylaxe benutzt. Fünfundachtzig Prozent von alien prophylaktischen Behandlungen dauerten 8 Tage oder mehr.
Einundfünfzig Prozent von alien unter dem studierten Zeitraum verabreichter Antibiotika, wurden als Prophylaxe bei reinen orthopadischen Eingriffen benutzt.
Die Dauer des Krankenhausaufenthaltes war der einzige Faktor von Bedeutung für die Dauer der antibiotischen Prophylaxe.
Die penicillinaseresistenten Penicilline waren die für die Prophylaxe meist benutzten. Wir fanden eine signifikative Erhöhung der Häufigkeit der gramnegativen Bakterien in den Wunden der Patienten, die die antibiotische Prophylaxe enthielten.
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Surin, V., Borgström, E. & Bäckman, L. Use of prophylactic antibiotics in orthopedic surgery. Arch. Orth. Traum. Surg. 99, 175–181 (1982). https://doi.org/10.1007/BF00379205
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DOI: https://doi.org/10.1007/BF00379205