{"id":29557,"date":"2026-03-02T04:57:00","date_gmt":"2026-03-01T20:57:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29557"},"modified":"2026-03-02T05:45:02","modified_gmt":"2026-03-01T21:45:02","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%ce%b2-%e5%86%85%e9%85%b0%e8%83%ba%e4%b8%8e%e9%9d%9e%ce%b2-%e5%86%85%e9%85%b0%e8%83%ba%e6%8a%97%e7%94%9f%e7%b4%a0%e9%a2%84%e9%98%b2","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29557","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u03b2-\u5185\u9170\u80fa\u4e0e\u975e\u03b2-\u5185\u9170\u80fa\u6297\u751f\u7d20\u9884\u9632\u548c\u624b\u672f\u90e8\u4f4d\u611f\u67d3"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Surgery<\/p>\n\n\n\n

\u03b2-Lactam vs Non\u2013\u03b2-Lactam Antimicrobial Prophylaxis and Surgical Site Infection<\/h1>\n\n\n\n

Selina Largiad\u00e8r, Delphine Berthod, Andreas Widmer, et al<\/h3>\n\n\n\n

JAMA Netw Open 2025;8;(10):e2540809. doi:10.1001\/jamanetworkopen.2025.40809<\/h3>\n\n\n\n

<\/a>Key Points<\/p>\n\n\n\n

Question<\/strong>  Is the administration of non\u2013\u03b2-lactam surgical antimicrobial prophylaxis (SAP) vs \u03b2-lactam SAP associated with increased surgical site infections (SSI)?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study of 348\u202f885 patients who underwent 1 of 10 major surgical procedures, non\u2013\u03b2-lactam SAP was associated with 1.8-fold higher odds of SSI.<\/p>\n\n\n\n

Meaning<\/strong>  These findings suggest that non\u2013\u03b2-lactam SAP should be avoided whenever possible and for patients with reported \u03b2-lactam allergy delabeling should be enforced.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  \u03b2-lactam\u2013based surgical antimicrobial prophylaxis (SAP) is the standard for most surgical procedures. Alternatively, and mostly due to allergies, non\u2013\u03b2-lactam\u2013based prophylaxis is used. The association between the use of non\u2013\u03b2-lactam SAP and an increased risk of surgical site infection (SSI) rate has not yet been conclusively described.<\/p>\n\n\n\n

Objective<\/strong>  To assess whether non\u2013\u03b2-lactam vs \u03b2-lactam prophylaxis is associated with the occurrence of SSI.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This cohort study was based on the Swissnoso SSI surveillance system of 175 hospitals, including adult patients who underwent a major surgical procedure with SAP administration within 120 minutes prior to incision and postdischarge follow-up from January 2009 to December 2020. Patients with wound contamination class IV were excluded. Data analysis was conducted from July to December 2024.<\/p>\n\n\n\n

Exposures<\/strong>  \u03b2-Lactam SAP vs non\u2013\u03b2-lactam SAP.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The main outcome was occurrence of SSI, according to Centers for Disease Control and Prevention definitions. Mixed-effects logistic regression models were used to adjust for institutional, patient, and perioperative confounding factors.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Of 538\u202f976 surveilled patients, 348\u202f885 (196\u202f411 [56.3%] female; median [IQR] age, 63.2 [47.0-73.3] years) fulfilled eligibility criteria. \u03b2-Lactam SAP was administered in 342\u202f936 patients (98.3%) and non\u2013\u03b2-lactam SAP in 5949 patients (1.7%). SSI was diagnosed in 9507 patients (2.8%) exposed to \u03b2-lactam SAP vs 364 patients (6.1%) who received non\u2013\u03b2-lactam SAP (P<\/em>\u2009<\u2009.001). Non\u2013\u03b2-lactam SAP was significantly associated with a higher SSI rate (adjusted odds ratio [aOR], 1.78; 95% CI, 1.59-1.99;\u00a0P<\/em>\u2009<\u2009.001) compared with \u03b2-lactam SAP. A higher SSI rate for non\u2013\u03b2-lactam SAP was found across all procedure types. Secondary analyses found a higher risk of SSI for ciprofloxacin (aOR, 1.57; 95% CI, 1.33-1.87;\u00a0P<\/em>\u2009<\u2009.001), vancomycin (aOR, 1.38; 95% CI, 1.03-1.86;\u00a0P<\/em>\u2009=\u2009.04), and clindamycin (aOR, 2.12; 95% CI, 1.82-2.47;\u00a0P<\/em>\u2009<\u2009.001) compared with \u03b2-lactam SAP.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this large cohort study, administration of non\u2013\u03b2-lactam SAP was associated with 1.8-fold higher odds of SSI. These findings suggest that non\u2013\u03b2-lactam SAP should be avoided whenever possible. A careful evaluation of patients with reported \u03b2-lactam allergy should be performed before administering a second-choice antibiotic.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Surgery \u03b2-Lactam vs Non\u2013\u03b2- […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29557"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=29557"}],"version-history":[{"count":3,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29557\/revisions"}],"predecessor-version":[{"id":30146,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29557\/revisions\/30146"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29557"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29557"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29557"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}