دورية أكاديمية
أعرض في EDS

Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation.

التفاصيل البيبلوغرافية
العنوان: Intraoperative Redosing of Surgical Antibiotic Prophylaxis in Addition to Preoperative Prophylaxis Versus Single-dose Prophylaxis for the Prevention of Surgical Site Infection: A Meta-analysis and GRADE Recommendation.
المؤلفون: Wolfhagen N; Department of Surgery, Amsterdam UMC (location AMC), Amsterdam Gastroenterology Endocrinology & Metabolism (AGEM), University of Amsterdam, The Netherlands., Boldingh QJJ, de Lange M, Boermeester MA, de Jonge SW
المصدر: Annals of surgery [Ann Surg] 2022 Jun 01; Vol. 275 (6), pp. 1050-1057. Date of Electronic Publication: 2022 Mar 11.
نوع المنشور: Journal Article; Meta-Analysis
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 0372354 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1528-1140 (Electronic) Linking ISSN: 00034932 NLM ISO Abbreviation: Ann Surg Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Philadelphia, PA : Lippincott Williams & Wilkins
مواضيع طبية MeSH: Antibiotic Prophylaxis*/methods , Surgical Wound Infection*/drug therapy , Surgical Wound Infection*/epidemiology , Surgical Wound Infection*/prevention & control, Anti-Bacterial Agents/therapeutic use ; Cohort Studies ; Humans ; Incidence
مستخلص: Objective: The aim of this study was to determine the effect of preoperative surgical antibiotic prophylaxis (SAP) with additional intraoperative redosing compared to single-dose preoperative surgical antibiotic prophylaxis on the incidence of surgical site infections (SSI).
Summary Background Data: Preoperative SAP is standard care for the prevention of SSI. During long surgical procedures, additional intraoperative redosing of SAP is advised, but there is great variability in redosing strategies and compliance rates.
Methods: We performed a systematic search of MEDLINE (PubMed), Embase, CINAHL and CENTRAL on June 25th, 2021 according to PROSPERO registration CRD42021229035. We included studies that compared the effect of preoperative SAP with additional intraoperative redosing to single dose preoperative SAP (no redosing) on SSI incidence in patients undergoing any type of surgery. Two researchers performed data appraisal and extraction of summary data independently. Meta-analyses were stratified per study type. We used a generic inverse variance random-effects model to estimate a pooled odds ratio with corresponding 95% confidence intervals (CIs).
Results: We included 2 randomized controlled trials (RCT) and 8 cohort studies comprising of 9470 patients. Pooled odds ratios for SSI in patients receiving intraoperative redosing compared to those without redosing were 0.47 (95% CI: 0.19-1.16. I2 = 36%) for RCTs and 0.55 (95% CI: 0.38-0.79, I2 = 56%) for observational cohorts. There was considerable clinical heterogeneity among antibiotics used and redosing protocols. GRADE-assessment showed overall low certainty of evidence.
Conclusion: Intraoperative redosing of SAP may reduce incidence of SSI compared to a single dose preoperative SAP in any type of surgery, based on studies with considerable heterogeneity of antibiotic regimens and redosing protocols.
Competing Interests: The authors report no conflicts of interest.
(Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)
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المشرفين على المادة: 0 (Anti-Bacterial Agents)
تواريخ الأحداث: Date Created: 20220311 Date Completed: 20220531 Latest Revision: 20230328
رمز التحديث: 20231215
DOI: 10.1097/SLA.0000000000005436
PMID: 35275885
قاعدة البيانات: MEDLINE
الوصف
تدمد:1528-1140
DOI:10.1097/SLA.0000000000005436