目的:鼻中隔和隆鼻是耳鼻喉科常见的手术,通常合并为鼻中隔成形术(SRP),提供美学和功能的好处。由于鼻孔中的天然细菌菌群,这些手术被认为可能存在术后感染的风险。这项研究评估了预防性抗生素在减少手术后感染并发症中的有效性。
方法:使用PubMed进行了系统评价,科克伦,和WebofScience,坚持PRISMA准则,专注于在鼻中隔成形术中使用抗生素,隆鼻,SRP。这项研究包括随机对照试验,单/双盲研究,回顾性图表回顾,和前瞻性队列研究,不包括儿科,非人类研究,或具有无法访问数据的研究。术后感染率采用R软件进行统计分析。
结果:来自697篇文章,选择了15项研究进行荟萃分析,涉及2225名患者,1274人接受预防性抗生素治疗,951人作为对照。荟萃分析表明比值比为0.65(95%CI:[0.23,1.89]),显示预防性抗生素没有显著的保护作用。
结论:研究发现预防性使用抗生素并没有显著降低感染率。值得注意的是研究设计的不一致,抗生素给药时机,和各种外科手术。考虑了抗生素使用风险。研究的局限性包括潜在的偏见和许多研究的回顾性性质。
结论:本综述和荟萃分析没有发现实质性证据支持预防性使用抗生素在降低鼻中隔成形术术后感染率方面的有效性,隆鼻,SRP,表明需要重新评估实践和制定循证指南。未来的研究应该集中在全面,随机对照研究,涵盖术前和术后阶段。
OBJECTIVE: Septoplasty and rhinoplasty are common otolaryngological procedures, often combined as septorhinoplasty (SRP), offering aesthetic and functional benefits. These surgeries are believed to potentially risk postoperative infections due to natural bacterial flora in the nares. This study evaluates the effectiveness of prophylactic antibiotics in reducing post-surgical infection complications.
METHODS: A systematic
review was conducted using PubMed, Cochrane, and Web of Science, adhering to PRISMA guidelines, focusing on antibiotic use in septoplasty, rhinoplasty, and SRP. The study included randomized control trials, single/double-blind studies, retrospective chart reviews, and prospective cohort studies, excluding pediatric, non-human research, or studies with inaccessible data. Postoperative infection rates were analyzed utilizing R software as a form of Statistic.
RESULTS: From 697 articles, 15 studies were chosen for meta-analysis, involving 2225 patients, with 1274 receiving prophylactic antibiotics and 951 as controls. The meta-analysis indicated an odds ratio of 0.65 (95 % CI: [0.23, 1.89]), showing no significant protective effect of prophylactic antibiotics.
CONCLUSIONS: The study found no significant infection rate reduction with prophylactic antibiotic use. Notable were inconsistencies in study designs, antibiotic administration timing, and varied surgical practices. Antibiotic use risks were considered. Study limitations include potential biases and the retrospective nature of many studies.
CONCLUSIONS: This
review and meta-analysis found no substantial evidence supporting prophylactic antibiotics\' effectiveness in reducing postoperative infection rates in septoplasty, rhinoplasty, and SRP, indicating a need to reevaluate practices and develop evidence-based guidelines. Future research should focus on comprehensive, randomized control studies, covering both preoperative and postoperative stages.