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首页> 外文期刊>Infection and Drug Resistance >A systematic review and meta-analysis on the use of prophylactic topical antibiotics for the prevention of uncomplicated wound infections
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A systematic review and meta-analysis on the use of prophylactic topical antibiotics for the prevention of uncomplicated wound infections

机译：使用预防性局部抗生素预防单纯性伤口感染的系统评价和荟萃分析

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Background: The prescription of topical antibiotics for the prevention of infections in uncomplicated wounds is common. However, the efficacy is not well reported. Therefore, the objective of the study was to conduct a systematic review and meta-analysis of the available evidence on prevention of uncomplicated wound infections by prophylactic topical antibiotics. Materials and methods: The search included Pubmed, Google Scholar, SCOPUS, Embase, Cochrane, ClinicalTrials.gov, International Clinical Trials Registry Platform, National Technical Information Service, and the National Guidelines Clearinghouse. Results: We identified eight randomized controlled trials and four quasi-randomized trials that met the criteria for the systematic review. Of these trials, 11 studies were pooled for meta-analysis to compare the effects of topical antibiotics versus placebo and 4 studies were pooled for comparison of effects of topical antibiotics versus topical antiseptics on uncomplicated wounds. Fewer wound infections occurred in the topical antibiotic arms compared to placebo (pooled risk ratio: 0.57 [95% CI: 0.37 to 0.86]; p =0.01 and pooled risk difference: ?3.1% [95% CI: ?5.8% to ?0.34%]; p =0.03). Compared to antiseptics, topical antibiotics demonstrated statistically significant relative risk reduction (pooled risk ratio: 0.56 [95% CI: 0.23 to 0.91]; p =0.02), while there was no significant absolute risk reduction (pooled risk difference: ?3.7% [95% CI: ?7.9% to +0.6%]; p =0.09). Conclusion: Topical antibiotics are effective in reducing wound infections after surgical procedures, but the absolute benefit is small. Given the global emergence of antimicrobial resistance, judicious use of antibiotics is encouraged and use of antiseptics should be considered as a reasonable alternative to topical antibiotics.
机译：背景：外用抗生素预防简单伤口感染的处方很普遍。但是，疗效尚未很好报道。因此，研究的目的是对预防性局部抗生素预防单纯性伤口感染的现有证据进行系统的回顾和荟萃分析。材料和方法：搜索包括Pubmed，Google Scholar，SCOPUS，Embase，Cochrane，ClinicalTrials.gov，国际临床试验注册平台，国家技术信息服务和国家指南信息交换所。结果：我们确定了八项符合系统评价标准的随机对照试验和四项准随机试验。在这些试验中，收集了11项研究进行荟萃分析，以比较局部抗生素与安慰剂的作用，并收集了4项研究以比较局部抗生素与局部防腐剂对不复杂伤口的作用。与安慰剂相比，局部抗生素组伤口感染的发生率更低（合并风险比：0.57 [95％CI：0.37至0.86]; p = 0.01，合并风险差异：？3.1％[95％CI：？5.8％至0.34） ％]; p = 0.03）。与防腐剂相比，局部抗生素具有统计学上的显着相对危险度降低（合并风险比：0.56 [95％CI：0.23至0.91]; p = 0.02），而绝对危险度却没有显着降低（合并风险差：？3.7％[ 95％CI：≤7.9％至+ 0.6％; p ＝ 0.09）。结论：外用抗生素可有效减少手术后伤口感染，但绝对获益很小。鉴于全球出现了抗菌素耐药性，因此鼓励明智地使用抗生素，应考虑使用防腐剂作为局部抗生素的合理替代品。

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