Cefazolin Monotherapy Versus Cefazolin Plus Aminoglycosides for Antimicrobial Prophylaxis of Type III Open Fractures.

Autor:	Patanwala AE; School of Pharmacy, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia., Radosevich JJ; Department of Pharmacy Services, St. Joseph's Hospital and Medical Center, Phoenix, AZ., Meshay I; University of Arizona College of Medicine-Phoenix, Phoenix, AZ., Naderi M; Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ., Culver MA; Department of Pharmacy, Abrazo West Campus, Goodyear, AZ., Lee YG; Department of Pharmacy Services, St. Joseph's Hospital and Medical Center, Phoenix, AZ., Weinberg JA; Department of Surgery, St. Joseph's Hospital and Medical Center, Phoenix, AZ; and., Khobrani M; College of Pharmacy, King Khalid University, Abha, Saudi Arabia., Nix DE; Department of Pharmacy Practice and Science, College of Pharmacy, The University of Arizona, Tucson, AZ.
Jazyk:	angličtina
Zdroj:	American journal of therapeutics [Am J Ther] 2019 Nov 25; Vol. 28 (3), pp. e284-e291. Date of Electronic Publication: 2019 Nov 25.
DOI:	10.1097/MJT.0000000000001121
Abstrakt:	Background: There are conflicting recommendations between organizations regarding aminoglycoside use for the prophylaxis of type III open fractures. Study Question: To compare cefazolin monotherapy versus cefazolin plus aminoglycoside therapy for prophylaxis of type III open fractures in trauma patients. Study Design: This was a multicenter, retrospective, cohort study conducted in 3 academic medical centers in the United States. Consecutive adult trauma patients with type III open fractures between January 2014 and September 2016 were included. Patients were divided into 2 groups: (1) cefazolin monotherapy versus (2) cefazolin plus aminoglycoside. Measures and Outcomes: The primary outcome measure was the occurrence of infection at the open fracture site. The secondary outcome measure was the occurrence of acute kidney injury. Results: There were 134 patients included in the study cohort. Of these, 39 received cefazolin monotherapy and 95 received cefazolin plus aminoglycoside. Overall, the mean age was 39 ± 15 years, 105 (78%) were male, and the most common fracture location was tibia/fibula (n = 74, 56%). Infection at the open fracture site occurred in 6 of 39 patients (15%) in the cefazolin monotherapy group and 15 of 95 patients (16%) in the cefazolin plus aminoglycoside group (P = 1.000). Acute kidney injury occurred in 0 of 39 (0%) in the cefazolin monotherapy group and 1 of 95 (1%) in the cefazolin plus aminoglycoside group (P = 1.000). Conclusions: Cefazolin monotherapy may be appropriate for antimicrobial prophylaxis of type III open fractures in trauma patients. Competing Interests: The authors have no conflicts of interest to declare. (Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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