APPENDIX 1: Search Strategy on PubMed identified - PAHO
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Revista Panamericana de Salud Pública/Pan American Journal of Public Health
Supplementary material to: Brocard E, Reveiz L, Regnaux JP, Abdala V, Ramon Pardo P, Del Rio Bueno A. Antibiotic Prophylaxis
for Surgical Procedures: a scoping review. Rev Panam Salud Publica. 2021;45:e62. https://doi.org/10.26633/RPSP.2021.62
This material is part of the original submission and has been submitted to arbitration. It is published without editing as it has been sent
by the authors
APPENDIX 1: Search Strategy on PubMed identified
(("Antibiotic Prophylaxis"[MJ] OR ("Antibiotic Prophylaxis"[TI] OR "Antibiotic Premedication"[TI] OR
"Antibiotic Premedications"[TI]) OR (("Anti-Infective Agents"[MJ] OR "Anti-Bacterial Agents"[MJ] OR
antibiotic* OR alamethicin* OR amdinocillin* OR (amdinocillin pivoxil*) OR amikacin* OR amoxicillin* OR
("amoxicillin-potassium" clavulanate) OR amphotericin* OR ampicillin* OR anisomycin* OR antimycin*
OR aurodox* OR azithromycin* OR azlocillin* OR aztreonam* OR bacitracin* OR bacteriocin* OR
bambermycin* OR (bongkrekic acid*) OR brefeldin* OR (butirosin sulfate*) OR calcimycin* OR
candicidin* OR capreomycin* OR carbenicillin* OR carfecillin* OR cefaclor* OR cefadroxil* OR
cefamandole* OR cefatrizine* OR cefazolin* OR cefixime* OR cefmenoxime* OR cefmetazole* OR
cefonicid* OR cefoperazone* OR cefotaxime* OR cefotetan* OR cefotiam* OR cefoxitin* OR cefsulodin*
OR ceftazidime* OR ceftizoxime* OR ceftriaxone* OR cefuroxime* OR cephacetrile* OR cephalexin* OR
cephaloglycin* OR cephaloridine* OR cephalosporin* OR cephalothin* OR cephamycin* OR cephapirin*
OR cephradine* OR chloramphenicol* OR chlortetracycline* OR citrinin* OR clarithromycin* OR
(clavulanic acid*) OR clindamycin* OR cloxacillin* OR colistin* OR cyclacillin* OR dactinomycin* OR
daptomycin* OR demeclocycline* OR dibekacin* OR dicloxacillin* OR (dihydrostreptomycin sulfate*) OR
diketopiperazine* OR distamycin* OR doxycycline* OR echinomycin* OR edeine* OR enviomycin* OR
erythromycin* OR filipin* OR floxacillin* OR fluoroquinolone* OR fosfomycin* OR framycetin* OR (fusidic
acid*) OR gentamicin* OR gramicidin* OR hygromycin* OR imipenem* OR josamycin* OR kanamycin*
OR kitasamycin* OR lactam* OR lasalocid* OR leucomycin* OR lincomycin* OR lincosamide* OR
lucensomycin* OR lymecycline* OR mepartricin* OR methacycline* OR methicillin* OR mezlocillin* OR
mikamycin* OR minocycline* OR miocamycin* OR moxalactam* OR mupirocin* OR mycobacillin* OR
nafcillin* OR natamycin* OR nebramycin* OR neomycin* OR netilmicin* OR netropsin* OR nigericin* OR
nisin* OR norfloxacin* OR novobiocin* OR nystatin* OR ofloxacin* OR oleandomycin* OR oligomycin*
OR oxacillin* OR oxytetracycline* OR paromomycin* OR (penicillanic acid*) OR (penicillic acid*) OR
penicillin* OR piperacillin* OR pivampicillin* OR polymyxin b* OR polymyxin* OR pristinamycin* OR
prodigiosin* OR ribostamycin* OR rifabutin* OR rifamycin* OR ristocetin* OR rolitetracycline* OR
roxarsone* OR roxithromycin* OR rutamycin* OR sirolimu* OR sisomicin* OR spectinomycin* OR
spiramycin* OR streptogramin** OR streptomycin* OR streptovaricin* OR sulbactam* OR sulbenicillin*
OR sulfamerazine* OR sulfamethoxypyridazine* OR talampicillin* OR teicoplanin* OR tetracycline* OR
thiamphenicol* OR thienamycin* OR thiostrepton* OR ticarcillin* OR tobramycin* OR troleandomycin*
OR tunicamycin* OR tylosin* OR tyrocidine* OR tyrothricin* OR valinomycin* OR vancomycin* OR
vernamycin* OR viomycin* OR virginiamycin* OR "beta-lactams") AND (Prophylaxis OR prevention OR
premedication OR prophylactic*)) AND (surgery[CT] OR "Surgical Procedures, Operative" OR "Ghost
Surgery" OR "Operative Procedure" OR "Operative Procedures" OR "Operative Surgical Procedure" OR
"Operative Surgical Procedures" OR "Procedure, Operative" OR "Procedure, Operative Surgical" OR
"Procedures, Operative" OR "Procedures, Operative Surgical" OR "Surgery, Ghost" OR "Surgical
Procedure, Operative" OR E04*[MH] OR "non-surgical"[TI] OR "non surgical"[TI] OR "Non-surgical
procedure" OR "non-operative procedure" OR "Non-surgical procedures" OR "non-operative
procedures")) NOT ("Periodontal Diseases"[MH] OR "Surgery, oral"[MH] OR dentistry[MH] OR "Surgery,
Oral" OR Exodontics OR "Maxillofacial Surgery" OR "Oral Surgery" OR "Surgery, MaxillofacialAPPENDIX 2: Quality assessment scores of the included systematic review, from lowest to highest. Study ID AMSTAR 2 score Carney et al. 2018 Critically Low quality score Blood et al. 2017 Critically Low quality score Ghobrial et al. 2015 Critically Low quality score Fernicola et al. 2020 Critically Low quality score Cussans et al. 2016 Critically Low quality score La Regina et al. 2020 Critically Low quality score Foster et al. 2018 Critically Low quality score Soteropulos et al. 2019 Critically Low quality score Abraham et al. 2017 Critically Low quality score Vijendren et al. 2019 Critically Low quality score Hussain et al. 2018 Critically Low quality score Al-Abduljabbar et al. 2017 Critically Low quality score Jaworski et al. 2019 Critically Low quality score Gouvêa et al. 2015 Critically Low quality score Mocanu et al. 2019 Critically Low quality score Mayne et al. 2018 Low quality score King et al. 2018 Low quality score Shao et al. 2019 Low quality score Tanner et al. 2015 Low quality score Song et al. 2016 Low quality score Vander Poorten et al. 2020 Low quality score Moldovan et al. 2019 Low quality score Huang et al. 2016 Low quality score Xu et al. 2016 Low quality score Di Spiezio et al. 2016 Low quality score Gandra et al. 2018 Low quality score Weiss et al. 2019 Low quality score
Tan et al. 2020 Low quality score Nguyen et al. 2016 Low quality score Hajibandeh et al. 2019 Moderate quality score Erdas et al. 2016 Moderate quality score Thornley et al. 2015 Moderate quality score Yao et al. 2018 Moderate quality score Sanders et al. 2019 Moderate quality score Sadigursky et al. 2019 Moderate quality score Modha et al. 2018 Moderate quality score Morgenstern et al. 2018 Moderate quality score Musters et al. 2015 Moderate quality score Yang et al. 2016 Moderate quality score Noreikaite et al. 2018 Moderate quality score Carey et al. 2015 Moderate quality score Kim et al. 2018 Moderate quality score Liang et al. 2016 Moderate quality score Alrammaal et al. 2019 Moderate quality score Liu et al. 2019 Moderate quality score Carter et al. 2017 Moderate quality score Guo et al. 2019 Moderate quality score Lynch et al. 2018 Moderate quality score Loggini et al. 2020 Moderate quality score Nuyen et al. 2019 Moderate quality score Kessel et al. 2015 Moderate quality score Texakalidis et al. 2019 Moderate quality score Ramos et al. 2016 Moderate quality score de Jonge et al. 2017 Moderate quality score Purba et al. 2018 Moderate quality score Baltodano et al. 2019 Moderate quality score Voigt et al. 2016 High quality score Sousa et al. 2019 High quality score
Siddiqi et al. 2019 High quality score Zhang et al. 2019 High quality score Peng et al. 2019 High quality score Joaquim et al. 2019 High quality score Zeng et al. 2019 High quality score Brand et al. 2019 High quality score Matsui et al. 2018 High quality score Boonchan et al. 2017 High quality score Almeida et al. 2015 High quality score Bollig et al. 2018 High quality score Nabhan et al. 2016 High quality score Gallagher et al. 2019 High quality score Zapata-Copete et al. 2017 High quality score Ayeleke et al. 2017 High quality score Pop-Vicas et al. 2019 High quality score Habib et al. 2019 High quality score Bowen et al. 2018 High quality score Gower et al. 2017 High quality score Bokhari et al. 2019 High quality score Alotaibi et al. 2016 High quality score Liu et al. 2017 High quality score Guo et al. 2019 High quality score Srisung et al. 2017 High quality score Liu et al. 2018 High quality score López-Cano et al. 2019 High quality score
APPENDIX 3: Detailed summary of systematic reviews characteristics (study design, surgical procedure, antibiotics reported) and their key findings.
Study ID Study Design Surgical Procedure Antibiotics reported Key findings for Primary Outcomes
Thornley P, Evaniew N, Riediger M, Winemaker M, Bhandari M, Ghert M. Postoperative Systematic review and Meta-analysis Total joint arthroplasty Nafcillin or cefazolin, teicoplanin, cefuroxime SSI incidence higher (3.1%) of the 2055 patients given postoperative antibiotic prophylaxis and in 45 (2.3%) of the 1981 in the no-treatment group. Non statistically significant findings on
antibiotic prophylaxis in total hip and knee arthroplasty: a systematic review and meta- postoperative antibiotic prophylaxis for reduction of SSI rates (risk difference 0.01, 95% CI 0.00 to 0.02; heterogeneity I2 = 26%).
analysis of randomized controlled trials. CMAJ Open. 2015;3(3): E338-E343.
Voigt, J., Mosier, M. & Darouiche, R. Antibiotics and antiseptics for preventing infection Systematic review and Meta-analysis Total joint arthroplasty 1st vs. 2nd generation cephalosporin, mupirocin Statistically significant findings comparing vancomycin impregnated cement + IV cefazolin to IV cefazolin in revision TKA procedures (P = 0.0129). Non-significant findings on the 1 year
in people receiving revision total hip and knee prostheses: a systematic review of outcome of infection when comparing 1st generation vs. 2nd generation cephalosporins in TKA revision (RR = 0.29; 95% CI: 0.01 to 6.95; P = 0.45). Non-significant findings for the comparison
randomized controlled trials. BMC Infect Dis 2016; 16, 749. https://doi. mupirocin vs. povidone iodine (PI) on the outcome of infection at 30 days for either revision THA or revision TKA.
org/10.1186/s12879-016-2063-4
Mayne AIW, Davies PSE, Simpson JM. Antibiotic treatment of asymptomatic bacteriuria Systematic review Hip and knee arthroplasty Vancomycin, Cefazolin, Cefuroxime, Teicoplanin The 3 included studies do not support the routine antibiotic treatment of asymptomatic bacteriuria in arthroplasty patients. No statistically significant difference in infections rates found in
prior to hip and knee arthroplasty; a systematic review of the literature. Surgeon. either of the studies between patients with asymptomatic bacteriuria treated preoperatively with antibiotics compared to non-treated ASB patients undergoing hip and knee arthroplasty.
2018;16(3):176-182. doi:10.1016/j.surge.2017.08.00
Carney J, Heckmann N, Mayer EN, Alluri R, Vangsness C, Hatch G et al. Should antibiotics be Systematic review and Meta-analysis Arthroscopic knee surgery Vancomycin, cefazolin Stastistically significant difference in post-operative septic arthritis (RR 0.53, 95% CI 0.29-0.99, P = 0.05) for patients (excluding those with graft procedure)(0.08%) who received prophylactic
administered before arthroscopic knee surgery? A systematic review of the literature. World J antibiotics compared to those who received none (0.15%). Cases were higher for the non-antibioitc group (0.15% vs 0.08%). Sub-group analysis excluding bony procedures found no
Orthop. 2018;9(11):262-270. Published 2018 Nov 18. doi: 10.5312/wjo.v9.i11.262 significant difference in infection rates between administration of prophylactic antibiotics and no antibiotics (P > 0.05). Results showed higher post-operative septic arthritis cases (1.74%) for
people undergoing cruciate ligament reconstruction who received IV antibioitics alone compared to no infections for those who received IV antibiotics and had a vancomycin soaked graft (RR
0.01, 95%CI: 0.001-0.229, P < 0.01).
King J. D., Hamilton D. H., Jacobs C. A. and Duncan S. T. The Hidden Cost of Commercial Systematic review and Meta-analysis Total knee anthroplasty Gentamicin, Cefuroxime, Tobramycin, Erythromycin, Cefazolin, Antibiotic-Loaded Bone Cement did not reduce PJI prevalence compared to Plain Bone Cement (1.1% vs 0.9%; P = .09). Estimated costs per 1000 primary TKAs were: 2 bags of ALBC =
Antibiotic-Loaded Bone Cement: A Systematic Review of Clinical Results and Cost Vancomycin $430,000/y, 1 bag of ALBC +1 bag of plain cement = $275,000/y, and 2 bags of plain cement = $120,000/y.
Implications Following Total Knee Arthroplasty. J Arthroplasty.2018;33(12):3789-3792.
doi:10.1016/j.arth.2018.08.009.
Sousa RJG, Abreu MA, Wouthuyzen-Bakker M, Soriano AV. Is Routine Urinary Screening Systematic review and Meta-analysis Total joint arthroplasty Not stated Preoperative administration of antibiotics to treat Asymptomatic Bacteriuria (ASB) does not influence PJI risk after total joint arthroplasty (OR 0.98, 95% confidence interval = 0.39-2.44).
Indicated Prior To Elective Total Joint Arthroplasty? A Systematic Reviewand Meta-Analysis.
J Arthroplasty. 2019;34(7):1523-1530. doi:10.1016/j.arth.
2019.03.034
Siddiqi A, Forte SA, Docter S, Bryant D, Sheth NP, Chen AF. Perioperative Antibiotic Systematic review and Meta-analysis Total joint arthroplasty Cefazolin, Fucloxacillin, Erythromycin, Clindamycin, Cefamandole, No difference in effect between single preoperative dose of antibiotic and continued (preoperative plus postoperative) administration (RR 0.96; 95% CI, 0.73-1.26). However, the 95% CI for
Prophylaxis in Total Joint Arthroplasty: A Systematic Review and Meta-Analysis. J Bone Joint Cefuroxime, Amoxicillin/netilmicin, Gentamicin, Teicoplanin, the relative risk would include a reduction of approximately 27% in either group. No difference in effect between SAP of ≤24 and >24 hours postoperatively.
Surg Am. 2019;101(9):828-842. doi:10.2106/JBJS.18.00990 Fosfomycin, Lincomycin, Cloxacillin,
Zhang J, Zhang XY, Jiang FL, Wu Y, Yang B, Liu Z, et al. Antibiotic-impregnated bone cement Systematic review and Meta-analysis Total joint arthroplasty Gentamicin, Cefuroxime, Tobramycin, Erythromycin + Polymyxin, AIBC found to be more effective than systemic antibiotics (cefazolin) in reducing deep infection rates (OR 0.35, 95% CI 0.14-0.89, P = .030), but higher superficial infection rates with AIBC (OR
for preventing infection in patients receiving primary total hip and knee arthroplasty: A Cefazolin 1.53, 95% CI = 1.11-2.11, P = .010). Combination of AIBC and systemic antibiotics significantly decreased deep infection rates compared to systemic antibiotics alone, (OR 0.55, 95% CI = 0.41-
meta-analysis. Medicine (Baltimore). 2019;98(49):e18068. doi: 0.75, P = .0001) but no difference in superficial infection rates (OR 1.43, 95% CI = 0.81-2.54, P = .220). Both RCTs (OR 0.61, 95% CI = 0.37-0.99, P = .050) and cohort studies (OR 0.49, 95% CI =
10.1097/MD.0000000000018068 0.34-0.70, P = .0001) sub-group analysis found reduced deep infection rates after primary TJA. AIBC decreased deep infection rates in both total hip and knee arthroplasty (OR 0.25, 95% CI =
0.12-0.52, P = .0002 and OR 0.62, 95% CI = 0.45-0.87, P = .005, respectively).
Deep infection rates were significantly decreased by Gentamicin-IBC (OR 0.31, 95% CI = 0.20-0.49, P < .00001) but unaffected by Cefuroxime-IBC (OR 0.35, 95% CI = 0.10-
1.20, P = .100).
Yao R, Tan T, Tee JW, Street J. Prophylaxis of surgical site infection in adult spinesurgery: A Systematic review Spine surgery Intra-wound vancomycin powder, 1st and 3rd generation Grade C evidence supporting intra-wound vancomycin powder to reduce SSI. Grade B evidence showing that single dose of pre- SAP lowers SSI compared to no antibiotics, that perioperative
systematic review. J Clin Neurosci. 2018;52:5-25. doi:10.1016/j.jocn. 2018.03.023 Cephalosporins, Clindamycin multidose does not affect SSI rates compared to single preoperative dose for both lumbar spine surgery and lumbar fusion. Grade B evidence showing that when single dose preoperative
antibiotics are given, 3+ days of postoperative AP does not affect SSI rates compared to 2 days or less. Grade B evidence showing that SSI rates are not affected by extension of postoperative
AP after 24h for duration of drain usage in thoracolumbar spine surgery.
Blood AG, Sandoval MF, Burger E, Halverson-Carpenter K. Risk and Protective Factors Systematic review Spine surgery Cefazolin, Vancomycin Protective factors against postoperative SSI include antibiotic prophylaxis. One study showed that inadequate doses of cefazolin (£20mg/kg) led to greater risk of infection (18%) compared to
Associated with Surgical Infections among Spine Patients. Surg Infect (Larchmt). evidence-based doses (>20mg/kg) (infection rate 6.2%, OR=3.3, p=0.0002). One study found that multidoses of 1st-cephalosporins (pre and prolonged 5- 7 after surgery) led to higher SSI risk
2017;18(3):234-249. doi:10.1089/sur.2016.183 (0.8%) compared to single dose given preoperatively (0.4%).
Tan T, Lee H, Huang MS, Rutges J, Marion T, Mathew J, et al. Prophylactic postoperative Systematic review Spine surgery Not stated The use of postoperative AMP was not found to reduce SSI rate in lumbosacral spine surgery. Prolonged administration of AMP for more than 48 hours postoperatively does not seem to
measures to minimize surgical site infections in spine surgery: systematic review and reduce SSI rate in decompression-only nor lumbar spine fusion surgery. Administration of AMP in the presence of a wound drain did not seem to reduce the overall rate of SSI, deep nor
evidence summary. Spine J. 2020;20(3):435-447. doi:10.1016 superficial SSI in thoracolumbar fusion performed for degenerative and deformity spine pathologies, and in adolescent idiopathic scoliosis corrective surgery.
/j.spinee.2019.09.013
Peng XQ, Sun CG, Fei ZG, Zhou QJ. Risk Factors for Surgical Site Infection After Spinal Systematic review and Meta-analysis Spine surgery Not stated Results of 4 studies showed that no significant association was found between SSI and the use of prophylactic antibiotics (OR 1.43; 95% CI 0.69-2.98).
Surgery: A Systematic Review and Meta-Analysis Based on Twenty-Seven Studies. World
Neurosurgery. 2019;123:e318-e329. doi: 10.1016/j.wneu.
2018.11.158.
Fernandes J, Buzetti M, Walter D, Rolemberg D, Franz O, Eloy R et al. Intraoperative Systematic review and Meta-analysis Spine surgery Intra-wound vancomycin powder The RCTs indicated infection rates ofCussans A, Somani BK, Basarab A, Dudderidge TJ. The role of targeted prophylactic Systematic review and Meta-analysis Transrectal ultrasound-guided biopsy of the prostate (TRUSBP) Fluoroquinolone, ampicillin/clavulanic acid, cefadroxil, ceftriaxone, Post-biopsy infections rates were higher in groups given empirical prophylaxis (4.55%, 95% CI 3.80–5.44) compared with groups receiving targeted antimicrobial prophylaxis based on the results
antimicrobial therapy before transrectal ultrasonography-guided prostate biopsy in gentamicin, trimethoprim/sulfamethoxazole, cephalexin, of rectal culture (0.72%, 95% CI 0.44–1.18; P < 0.001). Sepsis rates were also higher in groups given empirical prophylaxis (2.21%, 95% CI 1.71–2.87) compared with targeted prophylaxis (0.48%,
reducing infection rates: a systematic review. BJU Int. 2016;117 (5):725-731. cefpodoxime, cephalosporins, amoxicillin/clavulanate, cephotaxime, 95% CI 0.26–0.88) (P < 0.001). The absolute risk reduction was 3.83% (95% CI 2.94–4.73).
doi:10.1111/bju.13402 meropenem, amikacin, ertapenem, cefuroxime, amoxicillin,
levofloxacin, cefdinir, aztreonam.
Noreikaite J, Jones P, Fitzpatrick J, Amitharaj R, Pietropaolo A, Vasdev N, et al. Fosfomycin Systematic review and Meta-analysis Transrectal ultrasound-guided biopsy of the prostate (TRUSBP) Fosfomycin and non-fosfomycin antimicrobials Lower UTIs were found in the fosfomycin cohort (M-H 0.20; 95% CI 0.13-0.30; p < 0.00001). Urine cultures from patients given fosfomycin showed significantly lower resistance rates (M-H
vs. quinolone-based antibiotic prophylaxis for transrectal ultrasound- guided biopsy of the 0.27; 95% CI 0.15-0.50; p < 0.0001).
prostate: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis.
2018;21(2):153-160. doi:10.1038/s41391-018-0032-2
La Regina D, Mongelli F, Fasoli A, Lollo G, Ceppi M, Saporito A, et al. Adverse Events after Systematic review and Meta-analysis Endoscopic colonoscopy Ampicillin and/or sulbactam, cefuroxime, levofloxacin or ceftazidime, All included studied showed a reduction in the rate of postoperative adverse events. The overall incidence rate was 2.4 and 19.9% in treatment and control groups, respectively.
Endoscopic Resection for Colorectal Lesions: A Meta-Analysis on the Antibiotic Prophylaxis. cefmetazole
Dig Dis 2020;38:15-22. doi: 10.1159/000502055
Zeng S, Zhang Z, Bai Y, Sun Y, Xu C. Antimicrobial agents for preventing urinary tract Systematic review and Meta-analysis Cystoscopy Fluoroquinolones, cephalosporins, and aminoglycosides Antibiotic prophylaxis may have little or no effect on the risk of systemic UTI compared with placebo or no treatment (RR 1.12, 95% CI 0.38 to 3.32) but may reduce the risk of symptomatic UTI
infections in adults undergoing cystoscopy. Cochrane Database Syst Rev. (RR 0.49, 95% CI 0.28 to 0.86). For adverse effects, inconclusive results were found as no study reported serious adverse events.
2019;2(2):CD012305. Published 2019 Feb 21. doi:10.1002/14651858.CD012305.
pub2
Carey MM, Zreik A, Fenn NJ, Chlosta PL, Aboumarzouk OM. Should We Use Antibiotic Systematic review and Meta-analysis Cystoscopy Democlocycline, ceftriaxone, norfloxacin, fosfomycin, trimethoprim, The OR for all three outcomes favoured the antibiotic group; the risk of developing symptomatic bacteriuria was 0.06 times more likely in the control group (OR 0.34), 0.054 (OR 0.40) for
Prophylaxis for Flexible Cystoscopy? A Systematic Review and Meta- Analysis. Urol Int. ciprofloxacin, trometamol, levofloxacin developing asymptomatic bacteriuria and 0.109 for confirming bacteriuria on MSU (OR 0.36). The number needed to treat (NNT) was 15 (13-19) for MSU positive bacteriuria; 32 (27-42) for
2015;95(3):249-259. doi:10.1159/000381882 symptomatic bacteriuria and 26 (23-33) for asymptomatic bacteriuria.
Brand M, Grieve A. Prophylactic antibiotics for penetrating abdominal trauma. Cochrane Systematic review Routine laparotomy 0 There is currently no information from RCTs to support or not the use of antibiotics for patients with penetrating abdominal trauma.
Database of Systematic Reviews 2019, Issue 12. Art. No.: CD007370. DOI:
10.1002/14651858.CD007370.pub4.
Kim SH, Yu HC, Yang JD, Ahn SW, Hwang HP. Role of prophylactic antibiotics in elective Systematic review and Meta-analysis Elective Laparoscopic cholecystectomy Cefazoline, Cefuroxime, cefotaxime, ceftriaxione In RCTs, prophylactic antibiotics did not prevent deep SSI (RR 1.10; 95% CI 0.45–2.69; p=0.84) but reduced overall SSI (RR 0.70, 95% CI 0.53–0.94; p=0.02), and superficial SSI (RR 0.58, 95% CI
laparoscopic cholecystectomy: A systematic review and meta-analysis. Ann Hepatobiliary 0.42–0.82; p=0.01). However, prospective studies showed prophylactic antibiotics did not reduce superficial SSI (RR 0.35, 95% CI 0.01–8.40; p=0.52) but reduced overall SSI (RR 0.12, 95% CI
Pancreat Surg. 2018;22(3):231-247. doi:10.14701/ahbps. 0.04–0.35, p=0.0001). Finally, results of retrospective studies found that antibiotic prophylaxis did not reduce overall SSI (RR 1.59, 95% CI [0.30–8.32], p=0.58). Pooled data of all designs
2018.22.3.231 showed similar results from RCTs, that prophylactic antibiotics were not effective in preventing deep SSI (RR 1.01 95% CI 0.46–2.21; p=0.98) but effective in reducing superficial SSI (RR 0.61,
95% CI [0.45–0.83], p=0.002) and overall SSI (RR 0.67, 95% CI 0.51–0.88; p=0.003).
Matsui Y, Satoi S, Hirooka S, Kosaka H, Kawaura T, Kitawaki T. Reappraisal of previously Systematic review and Meta-analysis Elective Laparoscopic cholecystectomy Not stated Antibiotic administration was found to reduce significantly rates of SSI (RR 0.71; 95% CI 0.51-0.99), distant (RR 0.37; 95% CI 0.19-0.73) and overall infections (RR 0.50; 95% CI 0.34-0.75).
reported meta-analyses on antibiotic prophylaxis for low-risk laparoscopic cholecystectomy:
an overview of systematic reviews. BMJ Open. 2018;8(3): e016666. Published 2018 Mar 16.
doi:10.1136/bmjopen-2017-016666
Liang B, Dai M, Zou Z. Safety and efficacy of antibiotic prophylaxis in patients undergoing Systematic review and Meta-analysis Elective Laparoscopic cholecystectomy Ciprofloxacin, cefuroxime, cefazolin, cefotetan, cefotaxime, Antibiotic prophylaxis reduced SSI incidence (RR 0.61; 95% CI 0.45-0.82; P = 0.001) and global infections (RR 0.55, 95% CI 0.38 to 0.79, P = 0.001) during hospitalization or after discharge, and
elective laparoscopic cholecystectomy: A systematic review and meta- analysis. J ceftriaxone and ceftazidime postoperative length of hospital stay (weighted mean difference -0.16, 95% CI -0.28 to -0.04, P = 0.008). No results for adverse events were reported.
Gastroenterol Hepatol. 2016;31(5):921-928. doi:10.1111/jgh.13246 Subgroup analyses showed that 2 doses (RR 0.16, 95% CI 0.06-0.47) of antibiotic and 3-10 doses (RR 0.46; 95% CI 0.27-0.80)of antibiotic significantly reduced SSi incidence
compared with placebo or no antibiotics. Single dose of antibiotic administration did not (RR 0.87; 95% CI 0.59-1.30).
Hajibandeh S, Popova P, Rehman S. Extended Postoperative Antibiotics Versus No Systematic review and Meta-analysis Emergency cholecystectomy. Ampicillin/sulbactam, Amoxicillin/clavulanic, Cefoxitin, No statistically significant difference was found between the 2 groups in terms of postoperative infectious complications (OR 0.94; P = .79), SSI (OR = 1.13, P = .72), postoperative morbidity (OR
Postoperative Antibiotics in Patients Undergoing Emergency Cholecystectomy for Acute Cefoxitin/cefaclor 0.93; P = .70), postoperative non infectious complications (OR 0.85, P = .57), urinary tract infections (OR = 0.69, P = .55), pneumonia (OR = 0.33, P = .14), length of hospital stay (mean
Calculous Cholecystitis: A Systematic Review and Meta-Analysis. Surg Innov. 2019;26(4):485- difference = 0.78, P = .25), postoperative mortality (risk difference = -0.00, P = .65), and need for readmission (OR = 0.87, P = .70).
496.
Foster D, Kethman W, Cai LZ, Weiser TG, Forrester JD. Surgical Site Infections after Systematic review and Meta-analysis Appendectomy Not stated Pooled SSI rate among patients who received preoperative antibiotics was 13.6 infections per 100 appendectomies (95% CI 8.9–18.2 infections/ 100 appendectomies) compared to 18.9
Appendectomy Performed in Low and Middle Human Development-Index Countries: A infections per 100 appendectomies (95% CI 8.0–29.7 infections/100 appendectomies) in studies where the use of preperative antibiotic was not specified.
Systematic Review. Surg Infect (Larchmt). 2018;19(3):237-244. doi:
10.1089/sur.2017.188
Erdas E, Medas F, Pisano G, Nicolosi A, Calò PG. Antibiotic prophylaxis for open mesh Systematic review and Meta-analysis Open mesh repair of groin hernia. Cefazolin, Amoxicillin/clavulanate, Ampicilin/sulbactam, Levofloxacin Results from RCTs showed that antibiotic prophylaxis significantly reduced the overall incidence of SSI from 4.8 % to 3.2 % (OR 0.68, 95 % CI (0.51-0.91). However, results were non-significant
repair of groin hernia: systematic review and meta-analysis. Hernia. 2016;20 (6):765-776. (OR 0.76; 95 % CI 0.56-1.02) after the removal of two outlier studies. Deep SSI incidence was very low (0-0.7 %) and the effect of antibiotic prophylaxis was not significant (OR 0.80, 95 % CI
doi:10.1007/s10029-016-1536-0 0.32-1.99).
Boonchan T, Wilasrusmee C, McEvoy M, Attia J, Thakkinstian A. Network meta- analysis of Systematic review and Meta-analysis Open mesh repair of groin hernia. First‐generation cephalosporins (intramuscular cephaloridine), The results indicated that β‐lactam/β‐lactamase inhibitors were the most effective antibiotic prophylaxis compared with placebo, with a pooled RR of 0·44 (95% CI 0.25 -0.75), followed by
antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery. Br J second‐generation cephalosporins (intravenous cefonicid), β‐ 1st‐generation cephalosporins, with a pooled RR of 0.62 (95% CI 0·42-0·92). Compared with 1st‐generation cephalosporins, β‐lactam/β‐lactamase inhibitors were most effective, whereas
Surg. 2017;104(2):e106-e117. doi:10.1002/bjs.10441 lactam/β‐lactamase inhibitors (intravenous amoxicillin– clavulanate) 2nd‐generation cephalosporins and fluoroquinolones were least effective; however, these effects were not statistically significant, with pooled RRs of 0·70 (0·36 -1·38), 1·32 (0·55-3·16) and
and fluoroquinolones. 1·23 (0·71-2·15) respectively. β‐Lactam/β‐lactamase inhibitors and fluoroquinolones seemed to be superior to 2nd-generation cephalosporins but this was not statistically significant (RRs
0·54 (0·21-1·39) and 0·94 (0·36-2·45) respectively. Finally, fluoroquinolone prophylaxis was associated with a 75% higher risk of SSI compared to β‐lactam/β‐lactamase inhibitors (RR 1.75;
95% CI 0·80-3·82), but this was not statistically significant.
Baltodano PA, Chattha A, Johnson PK, Kittredge J, Ricci JA, Patel A. Postoperative Prophylactic Systematic review and Meta-analysis Ventral hernia repair (VHR) Cefazolin or Ciprofloxacin. Pooled results showed that the overall SSI incidence among patients receiving postoperative antibiotics was 14.63 % (95% CI, 9.977–20.91) compared to 35.56% (95% CI, 28.93–42.79)
Antibiotics Reduce Surgical Site Infection Rates after Ventral Hernia Repair: A Systematic among the patients who did not. Overall, prophylactic postoperative antibiotic use was associated with significantly fewer SSIs in comparison with the control group (OR 0.31; 95% CI,
Review. The American Surgeon. 2019; (11):1228-1233 0.1829–0.5277, P < 0.01) Subgroup analysis excluding patients who underwent laparoscopic VHRs, revealed an incidence of SSIs of 15.12% among patients receiving postoperative
antibiotics compared to 36.3% among patients who did not (OR 0.31; 95% CI, 0.1626-0.5865, P < 0.01).
Weiss, Eric; McClelland, Paul; Krupp, James; Karadsheh, Murad; Brady, Mary Sue . Use of Systematic review Ventral hernia repair (VHR) Not stated One study directly evaluated the use of prolonged antibiotics (PPA) with closed suction drain after incisional VHR and results suggested that prolonged antibiotic prophylaxis lowered SSIs (OR
Prolonged Prophylactic Antibiotics with Closed Suction Drains in Ventral Abdominal Hernia 0.235, 95% CI 0.090–0.617, P 5 0.003). The rate of infection occurred in 37 % of patients not treated with prolonged antibiotic prophylaxis (only antibiotics at the time of the drain) and 15 %
Repair. The American Surgeon, 2019; 85 (4), 403-408 of patients treated with PPA. Two other study found no significant effect with PPA on SSI rates.
Almeida RA, Hasimoto CN, Kim A, Hasimoto EN, El Dib R. Antibiotic prophylaxis for surgical site Systematic review Liver transplantation Ceftriaxone plus metronidazole versus ampicillin‐sulbactam plus One trial (Nikeghbalian 2010) reported no differences between ceftriaxone plus metronidazole and ampicillin‐sulbactam plus ceftizoxime for prophylaxis of bacterial infection among liver
infection in people undergoing liver transplantation. Cochrane Database Syst Rev. 2015;(12). ceftizoxime transplant recipients in terms of rates of positive culture and changes in antibiotic type, fever episodes, and bacterial infection at specific sites (wound, urine, respiratory tract, blood, intra‐
doi:10.1002/14651858.CD010164.pub2 abdominal site) during the hospital course and mortality.
Song T-R, Rao Z-S, Qiu Y, et al. Fluoroquinolone prophylaxis in preventing BK polyomavirus Systematic review and Meta-analysis Renal transplantation Fluoroquinolone, levofloxacin, ciprofloxacin, quinolones 2 RCTs and 4 cohort studies compared fluoroquinolones vs no fluoroquinolone for BKV infection prevention and reported no difference in the incidence of BK viremia at 1 year post‐
infection after renal transplant: A systematic review and meta-analysis. Kaohsiung J Med Sci. transplantation. A higher incidence of BK viremia was found in those who received any fluoroquinolone compared with those who received none (14.4% vs. 7.1%, p = 0.04), and patients who
2016;32(3):152-159. doi:10.1016/J.KJMS.2016.01.004 received fluoroquinolone for 30 days had a higher incidence of BK viremia compared with those who received either fluoroquinolone for less than 30 days or did not receive fluoroquinolone
(16.5% vs. 7.6% or 7.1%; p = 0.02).
Hanadi H. Alrammaal, Hannah K. Batchelor, R. Katie Morris and Hsu P. Chong. Efficacy of Systematic review Cesaerian section Cefuroxime, Ampicillin/sulbactam There were no studies evaluating Cefuroxime concentrations in obese women undergoing C-section. For non-obese women, Cefuroxime plasma concentrations ranged from
perioperative cefuroxime as a prophylactic antibiotic in women requiring caesarean section: a 9.85 to 95.25 mg/L within 30–60 min of administration a single dose of 1500 mg, which is above the minimum inhibitory concentration (8 mg/L) for up to 3 h post-dose. No studies reported
systematic review. European Journal of Obstetrics and Gynecology and Reproductive Biology. on Cefuroxime concentration in adipose tissue. SSI rates were 4.7% and 6.8% after administration of a single 1500 mg dose of Cefuroxime administrated after cord clamping.
2019;242:71-78. https://doi.org/10.1016/j. ejogrb.2019.08.022
Bollig C, Nothacker M, Lehane C, Motschall E, Lang B, Meerpohl J. Prophylactic antibiotics Systematic review and Meta-analysis Cesaerian section Penicillin, Cephalosporin, Ceftriaxone, Ampicillin, Macrolide, Women who were given antibiotics preoperatively were 28% (RR 0.72, 95% CI 0.56–0.92) less likely to show infectious morbidity compared with those who received antibiotics after cord
before cord clamping in cesarean delivery: a systematic review. Acta Obstet Gynecol Azithromycin, Cefathiamidine, Ceftazidime, Ceftizoxime, Lincosamide, clamping. The risk of endomyometritis and/or endometritis was reduced by 43% (RR 0.57, 95% CI 0.40–0.82) and the risk of wound infection by 38% (RR 0.62, 95% CI 0.47–0.81) in those who
Scand. 2018;97(5):521-535. doi:10.1111/aogs.13276 Clindamycin received antibiotics preoperatively as compared to those who received antibiotics after cord clamping. For other maternal infections no significant differences were identified. The risk for
neonatal outcom s(deaths attributed to infection, sepsis, neonatal antibiotic treatment, intensive care unit admission or antibiotic‐related adverse events) was statistically different when
antibiotics were given before or after cord clamping.
Nabhan AF, Allam NE, Hamed Abdel-Aziz Salama M. Routes of administration of antibiotic Systematic review and Meta-analysis Cesaerian section Cephalosporins (cefamandole, cefazolin, ceforanide, cefotaxime, Non-significant difference between intravenous antibiotics and antibiotic irrigation for endometritis (RR 0.95, 95% CI 0.70-1.29, P = 0.74) nor wound infection (RR 0.49, 95% CI 0.17-1.43, P =
prophylaxis for preventing infection after caesarean section. Cochrane Database Syst Rev. and cefoxitin) and penicillins (mezlocillin). 0.19). Sensitivity analysis did not change the overall results neither for endometritis (RR 0.87, 95% CI 0.62-1.23) nor wound infections (RR 0.42, 95% CI 0.11-1.61).
2016;(6):CD011876. Published 2016 Jun 17. doi:10.1002
/14651858.CD011876.pub2
Liu D, Zhang L, Zhang C, Chen M, Zhang L, Li J et al. Different regimens of penicillin antibiotics Systematic review and Meta-analysis Cesaerian section Ampicillin, ampicillin-salbactam, mezlocillin, piperacillin, One study reported maternal sepsis as an outcome and showed no statistically significant difference between single dose and multidose administration in maternal sepsis (RR 3.05, 95% CI
given to women routinely for preventing infection after cesarean section: A systematic review piperacillin-tazobactam, amoxyicillin, and amoxicillin-clavulani 0.13 to 73.41). Five studies reported endometritis as an outcome and showed no statistically significant difference between single dose and multidose administration in endometritis (RR 1.05,
and meta analysis. Medicine (Baltimore). 2018;97(46):e11889. 95% CI 0.70-1.60). No statistical difference was found between the one-day and three-day groups in rates of maternal sepsis (RR 4.04, 95% CI 0.20–81.69), however a three-day course of
doi:10.1097/MD.0000000000011889 antibiotics probably reduced the rate of endometritis in the mother (RR 3.49, 95% CI 1.07–11.33). No statistically significant difference was reported between administration before skin
incision and after umbilical cord clamping in sepsis (RR 0.67, 95%CI 0.20–2.26), however administration before skin incision may lower the rate of endometritis (RR 0.21, 95%CI 0.10–0.45). No
statistical difference was reported between intravenous injection and lavage groups in rates of endometritis in the mother (RR 1.02, 95% CI 0.38–2.70). Finally, combination of penicillins with
an inhibitor probably lowered cases of endometritis (RR 0.39, 95% CI 0.21–0.72).
Carter EB, Temming LA, Fowler S, Eppes C, Gross G, Srinivas SK et al. Evidence- Based Systematic review and Meta-analysis Cesaerian section Not stated SSI rate was significantly lower after implementing an evidence-based bundle (baseline pooled rates 6.2% vs 2.0% intervention, pooled RR 0.33, 95% CI 0.25-0.43). Evidence-based bundles
Bundles and Cesarean Delivery Surgical Site Infections: A Systematic Review and Meta- were also associated with a lower rate of superficial or deep surgical site infection (baseline pooled rate 5.9% vs 1.1% intervention, pooled RR 0.19, 95% CI 0.12-0.32). The rate of
analysis. Obstetrics and Gynecology. 2017 Oct;130(4):735-746. DOI: endometritis was low at baseline and not significantly different after intervention (baseline pooled rate 1.3% vs 0.9% intervention, pooled RR 0.57, 95% CI 0.31-1.06).
10.1097/aog.0000000000002249.
Gallagher M, Jones DJ, Bell-Syer SV. Prophylactic antibiotics to prevent surgical site infection Systematic review and Meta-analysis Breast cancer surgery Azithromycin, Clarithromycin, Augmentin, Flucloxacillin, Cefazolin, Pooling of the results demonstrated that preoperative prophylactic antibiotics probably lowered SSI incidence for patients undergoing breast cancer surgery without reconstruction (RR 0.67;
after breast cancer surgery. Cochrane Database Syst Rev. 2019;9(9): CD005360. Dicloxacillin, Cefonicid, Ampicillin‐sulbactam, Gentamycin 95% CI 0.53-0.85). Sensitivity analysis excluding 3 studied still favoured preoperative antibioitc prophylaxis compared to no antibiotic (RR 0.74;95% CI 0.57- 0.96). One study compared
doi:10.1002/14651858.CD005360.pub5. perioperative antibiotic to no antibiotic and findings were inconclusive for SSI incidence (RR 0.11, 95% CI 0.01-1.95).
Soteropulos CE, Tang SYQ, Poore SO. Enhanced Recovery after Surgery in Breast Systematic review Breast reconstruction Cephalosporin Preoperative antibiotic administration was recommended in the majority of protocols (cephalosporin if no allergy) for autologous reconstruction patients. For alloplastic reconstruction, no
Reconstruction: A Systematic Review. J Reconstr Microsurg. 2019 Nov;35(9):695- 704. doi: studies reporting the use of postoperative antibiotics was retrieved.
10.1055/s-0039-1693699. Epub 2019 Aug 1. PMID: 31370092.
Zapata-Copete J, Aguilera-Mosquera S, García-Perdomo HA. Antibiotic prophylaxis in breast Systematic review and Meta-analysis Breast reduction surgery Cefonicid, Azythromicin, Cefazolin, Cephalexin, Cloxacillin, Overall SSI incidence was 10.5% for antibiotic group compared to 18.7% for the no antibiotic or placebo group.The overall risk difference for SSI was −0.08 (95% CI −0.14–
reduction surgery: A systematic review and meta-analysis. J Plast ReconstrAesthet Surg. Levofloxacin, Clindamycin −0.03), favoring antibiotic prophylaxis compared to placebo.
2017;70(12):1689-1695. doi:10.1016/j.bjps.2017.08.005Guo T, Chen B, Rao F, Wu P, Liu P, Liu Z, et al. Identifying the superior antibiotic Systematic review and Meta-analysis Breast surgeries Ampicilin, amoxicilin, cefazolin, cefonicid, azithromiycin, Results revealed that antibiotic prophylaxis significantly reduced the postoperative infection rate (OR 0.57; 95% CI 0.45–0.72); Test Z = 4.83; P = .000).
prophylaxis strategy for breast surgery: A network meta-analysis. Medicine (Baltimore). clarithromycin, tetracycline,flucloxacillin, cloxacillin, gentamicin,
2019;98(17):e15405. doi:10.1097/MD.0000000000015405 dicloxacillin.
Lynch JM, Sebai ME, Rodriguez-Unda NA, Seal S, Rosson GD, Manahan MA. Breast Systematic review and Meta-analysis Implant insertion in augmentation mammoplasty procedures. Gentamicin, Bacitracin and Cephalosporin Resulsts showed significant reductions in clinical infection (RR 0.52, 95% CI 0.33–0.81) and capsular contracture (RR 0.36, 95% CI 0.16–0.83) as a result of antibiotic irrigation.
Pocket Irrigation with Antibiotic Solution at Implant Insertion: A Systematic Review and
Meta-Analysis. Aesthetic Plast Surg. 2018;42(5):1179-1186. doi: 10.1007/s00266-018-
1166-2
Ayeleke RO, Mourad S, Marjoribanks J, Calis KA, Jordan V. Antibiotic prophylaxis for elective Systematic review and Meta-analysis Hysterectomy Cephalosporin versus penicillin; cephalosporin versus tetracycline; Vaginal hysterectomy: results showed that, compared to placebo, women who received antibiotic prophylaxis had fewer total postoperative infections (RR 0.28, 95% CI 0.19- 0.40), UTI (RR
hysterectomy. Cochrane Database Syst Rev. 2017;6(6):CD004637. doi: antiprotozoal versus lincosamide; ephalosporin versus antiprotozoal 0.58, 95% CI 0.43-0.77), pelvic infections (RR 0.28, 95% CI 0.20-0.39), and postoperative fevers (RR 0.43, 95% CI 0.34-0.54). No differences between any of the 4 antibiotics comparison groups
10.1002/14651858.CD004637.pub2 (cephalosporin vs penicillin; cephalosporin vs tetracycline; antiprotozoal vs lincosamide; antiprotozoal vs lincosamide) for any of the primary outcomes, except that fewer cases of total
postoperative infection and postoperative fever were reported in women who received cephalosporin than in those who received antiprotozoal. Finally, results were unavailable for most
primary outcomes for comparisons of combined antibiotics to a single on (cephalosporin+antiprotozoal vs cephalosporin, cephalosporin+antiprotozoal vs antiprotozoal,
penicillin+antiprotozoal vs penicillin).
Abdominal hysterectomy: results showed that, compared to placebo, women who received antibiotic prophylaxis of any class had fewer total postoperative infections (RR 0.38, 95% CI 0.21-
0.67), abdominal wound infections (RR 0.51, 95% CI 0.36-0.73), UTIs (RR 0.41, 95% CI 0.31-0.53), pelvic infections (RR 0.50, 95% CI 0.35-0.71), and postoperative fevers (RR 0.59, 95% CI 0.50-
0.70). No difference was found when comparing cephalosporin vs penicillin for any of the primary outcomes and results were
unclear when comparing penicillin antiprotozoal vs penicillin.
Pop-Vicas A, Johnson S, Safdar N. Cefazolin as surgical antimicrobial prophylaxis in Systematic review and Meta-analysis Hysterectomy Cefazolin, cefoxitin or cefotetan In terms of SSI incidence, cefazolin use was not inferior to its comparator in 12 of 13 individual RCTs included in the analysis. The meta-analysis summary estimate showed a significantly
hysterectomy: A systematic review and meta-analysis of randomized controlled trials. higher SSI risk with cefazolin versus cefoxitin or cefotetan (risk ratio, 1.7; 95% CI, 1.04–2.77; P = .03). However, most studies included nonstandardized dosing and duration of antimicrobial
Infect Control Hosp Epidemiol. 2019;40(2):142-149. doi:10.1017/ice.2018.286 prophylaxis, had indeterminate or high risk of bias, did not include patients with gynecological malignancies, and/or were older RCTs not reflective of current clinical practices.
Vander Poorten, V., Uyttebroek, S., Robbins, K.T., Rordigo J, de Bree R, Laenen A et al. Systematic review and Meta-analysis Head and Neck Surgery Cefazolin, ampicillin-sulbactam, and amoxicillin-clavulanate, 15 studies compared short- to long-term prophylaxis; treatment for more than 48 h did not further reduce wound infections. Results of 5 RCTs comparing clindamycin to ampicillin-
Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery: A Systematic Benzylpenicillin and clindamycin sulbactam, implied an increased infection rate for clindamycin-treated patients (OR = 2.73, 95% CI 1.50-4.97, p = 0.001).
Review and Meta-Analysis. Adv Ther. 2020; 37, 1360–1380. https://doi.
org/10.1007/s12325-020-01269-2
Moldovan ID, Agbi C, Kilty S, Alkherayf F. A Systematic Review of Prophylactic Antibiotic Systematic review Endoscopic endonasal transsphenoidal surgery Cefazolin, Ceftriaxone, Ceftazidime, Vancomycin, Clarithromycin, The review only included a limited number (4) observational studies assessing the effectiveness of prophylactic antibiotic use in patients with pituitary lesions undergoing EETS. No meta-
Use in Endoscopic Endonasal Transsphenoidal Surgery for Pituitary Lesions. World Amoxicillin/clavulanate, Cephalexin analysis was conducted but none of the evidence was able to provide conclusive evidence about the benefits of use to prevent 30 days post-EEST infectious complications such as meningitis
Neurosurg. 2019;128:408-414. doi:10.1016/j.wneu.2019.05.082 and sinusitis.
Vijendren, A., Borsetto, D., Barker, E., Manjaly, J. G., Tysome, J. R., Axon, P. R., Donnelly, N. Systematic review Cochlear implant (CI) surgery Cefazolin, Clindamycin / vancomycin, cefuroxime and co-amoxicla Intraoperative prophylactic antibiotics should be given to all patients undergoing CI. Findings of two studies (Hirsch et al. and Basavaraj et al) on prolonged prophylactic antibiotics showed
P., & et al. A systematic review on prevention and management of wound infections from increased infection rates in contradiction to a third study (Garcia-Valdecases et al.). Almosnino et al. study found no difference in wound inections between group with prolonged AP and
cochlear implantation.Clinical otolaryngology, 2019; 44 (6), group without. 2 studies looked at cefazolin as the antibiotic type given (Hirsch et al. and Almonisno et al.) and their results suggest its use to prevent post wound infections.
1059-1070. https://doi.org/10.1111/coa.13444
Loggini A, Vasenina VI, Mansour A, Das Horowitz P, Goldenberg et al. Management of Systematic review Brain injury surgery and treatment Not stated Results of the review did not provide details on perioperative antibiotic prophylaxis for civilians with penetrating brain injury nor evidence supporting its use.
civilians with penetrating brain injury: A systematic review. J Crit Care. 2020;56: 159-166.
doi:10.1016/j.jcrc.2019.12.026
Nuyen B, Kandathil CK, Laimi K, Rudy SF, Most SP, Saltychev M. Evaluation of Antibiotic Systematic review and Meta-analysis Rhinoplasty Penicillin or amoxicillin, with or without β-lactamase inhibition, Antibiotic treatments started on induction or perioperatively were administered intravenously, whereas therapy with antibiotics started postoperatively was administered orally. Dosages and
Prophylaxis in Rhinoplasty: A Systematic Review and Meta-analysis. JAMA Facial Plast Surg. clavulanate, erythromycin, Ampicillin, Propicillin durations varied with the duration of postoperative administration, ranging from 5 to 12 days. Two RCTs compared groups with antibiotic prophylaxis of different lengths of treatment (pre and
2019;21(1):12-17. doi:10.1001/jamafacial.2018.1187 post) and 3 RCTs compared antibiotics with placebo (3) or no treatment (1). The overall rate of infections within the pooled sample was 5.54% in cases and 6.53% in controls.The pooled RR of
infection when comparing postoperative antibiotics with placebo or no treatment, pre or peri operatively, was 0.92 (95% CI, 0.35-2.43; P = 0 .86). The pooled RR of infection when comparing
postoperative antibiotics with placebo or no treatment (excluding preoperative or perioperative antibiotics) is presented in Figure 3. The pooled RR was 0.43 (95% CI, 0.18-1.04; P = .06).
Results did not favoured postoperative antibiotic prophylaxis after rhinoplasty compared to pre-, peri and no treatment or placebo.
Habib AM, Wong AD, Schreiner GC, Satti KF, Riblet NB, Johnson HA et al. Postoperative Systematic review and Meta-analysis Surgery for maxillofacial fractures Penicillin G IV, Penicillin VIK, Amoxicillin, Augmentin, Vancomycin, The addition of postoperative antibiotic prophylaxis to a standard preoperative and/or perioperative antibiotic regimen showed no significant difference in the risk of SSI (RR 1.11; 95% CI
prophylactic antibiotics for facial fractures: A systematic review and meta-analysis. Amoxicillin/clavulanate, Cefotaxin, Mezlocillin/oxacillin, Cefotaxime, 0.86-1.44, P > .1). Subgroup analysis found no significant differences in the risk of SSI when focusing either on mandibular fractures (RR 1.22; 95% CI 0.92- 1.62) or open surgical techniques
Laryngoscope. 2019;129(1):82-95. doi:10.1002/lary.27210 Metronidazole, Cephazolin (RR1.02; 95% CI: 0.62-1.67). A sensitivity analysis did not find any significant differences in risk when restricting to RCTs (RR = 1.00; 95% CI: 0.61-1.67) or cohort studies (RR 1.21; 95% CI:
0.89-1.63).
Huang J, Wang X, Chen X, Song Q, Liu W, Lu L. Perioperative Antibiotics to Prevent Acute Systematic review and Meta-analysis Ophthalmologic surgeries Vancomycin/moxifloxacin Results suggested that the rate of postoperative endophthalmitis was lower in the group that received intracameral vancomycin/moxifloxacin group compared to the one who did not (OR
Endophthalmitis after Ophthalmic Surgery: A Systematic Review and Meta- Analysis. PLoS 0.20, 95% CI 0.10-0.42, pJaworski R, Kansy A, Dzierzanowska-Fangrat K, Maruszewski B. Surgery: Where Are We and Systematic review Pediatric Cardiac surgery Cefazolin, second-generation cephalosporin, gentamicin,penicillin In 14 studies time of first antibioitc dose was within 60 minutes before skin incision, and for one study it was administered at the induction of anesthesia. In 3 studies an additional dose was
Where Do We Go? A Systematic Review. Surgical Infections. 2019; 20 (4), 253- with b-lactamase inhibitors given at ECC initiation (same dosage as first dose), two studies focused on an additional dose of cefazolin (25 mg/kg and 30 mg/ 100 mL respectively) given at ECC priming. Six groups of
260.http://doi.org/10.1089/sur.2018.272 authors reported intraoperative redosing every 3-4 hours whereas one study reported an additional dose at the start of rewarming, one an additional dose after separation from ECC, and one
if ECC lasted more than two hours or the overall operation time exceeded 6 hours. Postoperative cefazolin administration was given every six hours (2 studies) or eight hours (5 studies) or in
only two doses, except in neonatal infants (You can also read
