A prospective, randomized, double-blinded, placebo-controlled clinical study on postoperative antibiotherapy in 150 arthroscopy-assisted tibial plateau leveling osteotomies in dogs.

Autor: Spencer DD; Metropolitan Veterinary Hospital, Copley, Ohio., Daye RM; Metropolitan Veterinary Hospital, Copley, Ohio.
Jazyk: angličtina
Zdroj: Veterinary surgery : VS [Vet Surg] 2018 Nov; Vol. 47 (8), pp. E79-E87. Date of Electronic Publication: 2018 Sep 28.
DOI: 10.1111/vsu.12958
Abstrakt: Objective: To determine the influence of a 7-day course of postoperative antibiotherapy (cefpodoxime) on surgical site infections (SSI) after tibial plateau leveling osteotomy (TPLO).
Study Design: Prospective, randomized, double-blinded, placebo-controlled clinical study.
Sample Population: One hundred fifty client-owned dogs, with consent.
Methods: Dogs undergoing arthroscopy-assisted TPLO were randomly assigned to 1 of 2 groups, the placebo group receiving perioperative cefazolin and 7 days of placebo medication after surgery or the treatment group receiving perioperative cefazolin and 7 days of postoperative cefpodoxime. Twenty-seven factors were analyzed for association with SSI by using univariate analysis, Fisher's exact test, or Wilcoxon rank-sum test.
Results: SSI rates did not differ (P = .34) between the placebo group (17%; 95% confidence level [CL] 7.94%-26.43%) and the treatment group (11% SSI; 95% CL 3.98%-18.88%). The probability that > 23% of dogs would benefit from postoperative antibiotherapy was less than 5%. The only association between the factors tested in this study and SSI involved the body weight (kg), with each 1 unit increase in kilogram weight increasing the odds of developing an SSI by 4.7%.
Conclusion: Although the wide CL may be consistent with a type II error, a 7-day course of cefpodoxime after arthroscopy-assisted TPLO did not influence postoperative SSI in the population tested here. In addition, only a small proportion of dogs would benefit from postoperative antibiotherapy under the conditions of our study.
Clinical Significance: These results should prompt surgeons to reconsider systematic antibiotherapy after TPLO and justify additional studies to determine whether dogs predisposed to infection could benefit from such an approach.
(© 2018 The American College of Veterinary Surgeons.)
Databáze: MEDLINE
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