Ann Rheum Dis:细菌性关节炎外科引流术后2周与4周抗生素治疗的比较

2019-04-20 xiangting MedSci原创

对化脓性关节炎进行初步手术灌洗后,至少对于手部和腕关节炎,2周的靶向抗生素治疗在治愈率、不良事件或后遗症方面并不劣于4周,并使得住院时间明显缩短。

成人原生关节细菌性关节炎术后抗生素治疗的最佳持续时间仍是未知的。

这是一项前瞻性、非盲法、随机、非劣效性研究,比较了成人原生关节细菌性关节炎外科引流后的2周与4周抗生素治疗。除外植入物相关性感染、无手术灌洗的发作和随访时间少于2个月的发作。

共招募了154例患者:4周组有77例,2周组77例。静脉注射抗生素治疗的中位长度分别为1天和2天。两组手术灌洗的中位数为1。3例患者(2%)出现感染复发:2周组1例(治愈率99%),4周组2例(治愈率97%)。研究组间的不良事件或后遗症的数量没有差异。在全部154例关节炎病例中,99例涉及手和手腕,为此进行了额外的亚组分析。在这个按照方案的亚组分析中,出现3次复发:2周组1次(治愈率97%);4周组2次(治愈率96%)。2周组中50%观察到后遗症,而4周组为55%,其中5例(13%)和6例(13%)需要进一步的治疗。

对化脓性关节炎进行初步手术灌洗后,至少对于手部和腕关节炎,2周的靶向抗生素治疗在治愈率、不良事件或后遗症方面并不劣于4周,并使得住院时间明显缩短。

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    2019-04-22 lmm397
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