{"id":30698,"date":"2026-07-06T04:13:00","date_gmt":"2026-07-05T20:13:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=30698"},"modified":"2026-07-06T05:40:21","modified_gmt":"2026-07-05T21:40:21","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e6%8b%a9%e6%9c%9f%e7%bb%93%e7%9b%b4%e8%82%a0%e6%89%8b%e6%9c%af%e7%9a%84%ce%b2-%e5%86%85%e9%85%b0%e8%83%ba%e4%b8%8e%e9%9d%9e%ce%b2","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=30698","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u62e9\u671f\u7ed3\u76f4\u80a0\u624b\u672f\u7684\u03b2-\u5185\u9170\u80fa\u4e0e\u975e\u03b2-\u5185\u9170\u80fa\u7c7b\u6297\u751f\u7d20\u9884\u9632"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

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

\u03b2-Lactam vs Non\u2013\u03b2-Lactam Prophylaxis in Elective Colorectal Surgery<\/h1>\n\n\n\n

Curtis D.\u00a0Collins,\u00a0Eric\u00a0Hartsfield,\u00a0Robert K.\u00a0Cleary,\u00a0et al<\/h3>\n\n\n\n

JAMA Netw Open 2026;9;(4):e266708.\u00a0doi:10.1001\/jamanetworkopen.2026.6708<\/h3>\n\n\n\n

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

Question<\/strong>  Are surgical prophylaxis regimens containing \u03b2-lactam antibiotics associated with lower surgical site infections (SSIs) compared with non\u2013\u03b2-lactam alternative regimens in patients undergoing colorectal operations when considering antibiotic timing and dose optimization?<\/p>\n\n\n\n

Findings<\/strong>  In this cohort study including 20\u202f140 procedures in adult patients receiving \u03b2-lactam and non\u2013\u03b2-lactam alternative prophylaxis for elective colorectal surgery, the use of \u03b2-lactam prophylaxis regimens was associated with increased guideline-concordant prophylaxis dosing and timing and reduced SSIs.<\/p>\n\n\n\n

Meaning<\/strong>  This study suggests that, regardless of differences in guideline-concordant dosing and timing, \u03b2-lactam surgical prophylaxis is associated with lower risk of SSIs compared with those who receive non\u2013\u03b2-lactam alternative regimens.<\/a><\/p>\n\n\n\n

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

Importance<\/strong>  Previous studies found reduced surgical site infections (SSIs) with \u03b2-lactam surgical infection prophylaxis compared with non\u2013\u03b2-lactam alternatives; however, variations in timing and dosing have been reported. Whether guideline-concordant preoperative antibiotic dosing or timing are associated with reported SSI differences between regimens is unclear.<\/p>\n\n\n\n

Objective<\/strong>  To evaluate the incidence of SSIs between patients receiving \u03b2-lactam and non\u2013\u03b2-lactam alternative prophylaxis, while controlling guideline-concordant dosing and timing.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This multicenter retrospective cohort study used data from a validated regional data registry. Adult patients (>18 years) receiving \u03b2-lactam and non\u2013\u03b2-lactam alternative prophylaxis for elective colorectal surgery between July 2012 and June 2021 were included. Analyses were performed at multiple intervals between March 2022 and January 2026.<\/p>\n\n\n\n

Exposures<\/strong>  Surgical prophylaxis regimens with \u03b2-lactam or non\u2013\u03b2-lactam alternative prophylaxis. Receipt of guideline-concordant prophylaxis dose and timing were variables of interest, defined using international guideline recommendations.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  The primary outcome was 30-day SSI. Modified Poisson regression with robust (sandwich) variance estimators was used to estimate adjusted risk ratios (ARRs) for SSI comparing \u03b2-lactam with non\u2013\u03b2-lactam alternative prophylaxis, adjusting for guideline-concordant dosing, timing, and other covariates; 1:1 propensity score matching was performed as a sensitivity analysis.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0Among 20\u202f140 procedures (female, 10\u202f423 [51.8%]; male, 9717 [48.2%]; mean [SD] age, 62.0 [13.8] years), 18\u202f098 (89.9%) received \u03b2-lactam prophylaxis and 2042 (10.1%) received non\u2013\u03b2-lactam alternative prophylaxis. Baseline characteristics differed between groups. Patients in the \u03b2-lactam cohort more commonly received guideline-concordant antibiotic dosing (15\u202f124 [83.6%] vs 1084 [53.1%];\u00a0P<\/em>\u2009<\u2009.001), guideline-concordant timing (16\u202f946 [93.6%] vs 1707 [83.6%];\u00a0P<\/em>\u2009<\u2009.001), or combined guideline-concordant dose and timing (14\u202f216 [78.6%] vs 751 [36.8%];\u00a0P<\/em>\u2009<\u2009.001), and had fewer SSIs (1114 [6.2%] vs 172 [8.4%];\u00a0P<\/em>\u2009<\u2009.001). After adjusting for confounders, \u03b2-lactam prophylaxis was associated with a lower risk of SSIs (ARR, 0.74; 95% CI, 0.63-0.87;\u00a0P<\/em>\u00a0< .001). Neither guideline-concordant dosing (ARR, 1.04; 95% CI, 0.91-1.20;\u00a0P<\/em>\u00a0= .54) nor timing (ARR, 1.13; 95% CI, 0.92-1.38;\u00a0P<\/em>\u00a0= .25) were associated with SSI risk.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  In this cohort study of elective colorectal surgery procedures, \u03b2-lactam surgical prophylaxis was associated with significantly lower SSI risk compared with non\u2013\u03b2-lactam alternatives. Differences in guideline-concordant dosing and timing between cohorts were not associated with SSI risk in adjusted analyses.<\/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\/30698"}],"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=30698"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30698\/revisions"}],"predecessor-version":[{"id":30699,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/30698\/revisions\/30699"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=30698"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=30698"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=30698"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}