{"id":29616,"date":"2026-01-18T04:23:00","date_gmt":"2026-01-17T20:23:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=29616"},"modified":"2026-01-18T05:43:44","modified_gmt":"2026-01-17T21:43:44","slug":"jama-surg%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87-%e9%9d%9e%ce%b2-%e5%86%85%e9%85%b0%e8%83%ba%e6%8a%97%e7%94%9f%e7%b4%a0%e4%bd%bf%e7%94%a8%ef%bc%8c%ce%b2-%e5%86%85%e9%85%b0%e8%83%ba%e8%bf%87%e6%95%8f","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=29616","title":{"rendered":"[JAMA Surg\u53d1\u8868\u8bba\u6587]: \u975e\u03b2-\u5185\u9170\u80fa\u6297\u751f\u7d20\u4f7f\u7528\uff0c\u03b2-\u5185\u9170\u80fa\u8fc7\u654f\u4e0e\u624b\u672f\u90e8\u4f4d\u611f\u67d3"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Non\u2013\u03b2-Lactam Antibiotic Use, \u03b2-Lactam Allergy, and Surgical Site Infections<\/h1>\n\n\n\n

Prateek Agarwal, Rohit Prem Kumar, Louise-Marie Oleksiuk, et al<\/h3>\n\n\n\n

JAMA Surg 2025;160;(11):1260-1267<\/h3>\n\n\n\n

doi:10.1001\/jamasurg.2025.3789<\/h3>\n\n\n\n

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

Question<\/strong>  Is the use of \u03b2-lactam antibiotics (eg, cephalosporins, penicillins) for surgical prophylaxis associated with fewer surgical site infections (SSIs) across surgical specialties?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study including a database of 49\u202f279 procedures, the use of non\u2013\u03b2-lactam antibiotics was associated with a higher incidence of SSI. When controlling for covariates and \u03b2-lactam allergy status, non\u2013\u03b2-lactam antibiotic use was significantly associated with SSI.<\/p>\n\n\n\n

Meaning<\/strong>  This study found that the use of \u03b2-lactam antibiotics for surgical prophylaxis was associated with lower SSI incidence compared with non\u2013\u03b2-lactams.<\/a><\/p>\n\n\n\n

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

Importance<\/strong>  Surgical site infections (SSIs) pose significant health and economic burdens. \u03b2-lactams are the recommended prophylactic antibiotics for most surgical procedures; however, the association of non\u2013\u03b2-lactam antibiotics with SSI incidence is controversial.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate the association between reported \u03b2-lactam allergy status, \u03b2-lactam antibiotics, and SSIs across various surgical specialties.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This was a retrospective cohort study of a prospectively recorded database. The setting was a quaternary health center. Included in the study were patients who underwent surgery from January 2021 to February 2024.<\/p>\n\n\n\n

Exposures<\/strong>  Study exposures included antibiotic choice and reported \u03b2-lactam allergy, with covariates including demographics, comorbidities, and procedure details.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary study outcome was 30- to 90-day SSI incidence.<\/p>\n\n\n\n

Results<\/strong>  The study included 49\u202f279 procedures across 10 specialties, with a total of 41\u202f100 patients (mean [SD] age, 61.0 [15.9] years; range, 13-103 years; 21\u202f237 male [51.7%]). Procedures with non\u2013\u03b2-lactam antibiotic use had a higher incidence of SSI than procedures with \u03b2-lactam antibiotic use (2.2% vs 1.3%; risk ratio [RR], 1.69; 95% CI, 1.28-2.01; P<\/em>\u2009<\u2009.001). Procedures in patients with reported \u03b2-lactam allergy had a higher incidence of SSI (1.8% vs 1.3%; RR, 1.38; 95% CI, 1.15-1.64; P<\/em>\u2009=\u2009.003). These associations were present in logistic regression as well. However, on controlling for covariates and \u03b2-lactam allergy, non\u2013\u03b2-lactam antibiotic use remained significantly associated with higher SSI incidence (odds ratio [OR], 1.33; 95% CI, 1.00-1.74; P<\/em>\u2009=\u2009.04), whereas the association between \u03b2-lactam allergy and SSI incidence became nonsignificant (OR, 1.21; 95% CI, 0.97-1.49; P<\/em>\u2009=\u2009.09). In subspecialty analysis, only orthopedic surgery retained a significant association between non\u2013\u03b2-lactam use and increased SSI (OR, 3.01; 95% CI, 1.41-6.01; P<\/em>\u2009=\u2009.003).<\/p>\n\n\n\n

\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n
\"\"\/<\/figure>\n\n\n\n

Conclusions and Relevance<\/strong>  This cohort study found that \u03b2-lactam prophylaxis was associated with significantly lower SSI rates than non\u2013\u03b2-lactam agents, and a reported \u03b2-lactam allergy did not independently predict infection risk. Implementation of an allergy-focused stewardship guideline was associated with a marked reduction in non\u2013\u03b2-lactam use, underscoring the importance of precise allergy assessment to avoid unnecessary alternative prophylaxis.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Non\u2013\u03b2-Lactam Antibiotic Us […]<\/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\/29616"}],"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=29616"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29616\/revisions"}],"predecessor-version":[{"id":29907,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/29616\/revisions\/29907"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=29616"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=29616"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=29616"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}