骨科手术植入物相关感染的抗菌药物合理选用

Rational Selection of Antibiotics for Implant Associated Infections in Orthopedic Surgery

骨科手术使用植入物的患者人数逐步增加,但植入物容易产生细菌或真菌感染,因此需预防性或治疗性使用抗菌药物。尽管使用抗菌药物能改善骨科手术植入物感染,但实际使用中抗菌药物的选择取决于感染的持续时间和发病机制、植入物的稳定性、病原体药敏和周围组织感染等情况,常存在不合理使用情况。现就骨科手术植入物感染机制,骨科植入物手术围术期抗菌药物使用、治疗用抗菌药物以及新型的抗菌药物进行综述,期望为进一步规范骨科手术植入物相关感染抗菌药物的合理使用提供思路。

The number of patients who were placed with implants after orthopedic surgery were gradually increasing,but implants are prone to bacterial or fungal infections,thus prophylactic or therapeutic use of antibiotics is required.Although the use of antibiotics can improve the infection of orthopedic implants,the choice of antibiotics depends on the duration and pathogenesis of the infection,the stability of the implant,the susceptibility of the pathogen and the infection of the surrounding tissues,and etc,however there are often irrational use cases.This article reviews the mechanism of implant infection in orthopedic surgery,perioperative use of antibiotics,therapeutic antibiotics and new antibiotics.The review expects to provide ideas for further regulating the rational use of antibiotics for implant related infections in orthopedic surgery.