Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.2.2 continued
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Nelson
2009
[1]
Systematic
review
All trials between 1980
to december 2007 concerning
the efficacy of
antimicrobial prophylaxis
for the prevention of postoperative
wound infection
in patients undergoing
colorectal surgery. 182
relevant trials were found
through Medline, EmBase
and Cochrane
I1: Antibiotics prophylaxis
(n=461)
I2: Single-dose (n=757)
I3: Aerobic cover + anaerobic
cover (n=648)
I4: Aerobic cover + anaerobic
cover (n=1 184 included)
I5: Combined non-absorbable
oral + intravenous
prophylaxis (n=1 176)
I6: Combined non-absorbable
oral + intravenous
prophylaxis (n=143)
I7: Antibiotic choice 28 trials
C1: No antibiotics
(n=352)
C2: Multiple doses
(n=1 784)
C3: No aerobic
cover (n=621)
C4: No anaerobic
cover (n=1 210)
C5: Intravenous
prophylaxis alone
(n=1 186)
C6: Oral nonabsorbable
prophylaxis
alone (n=140)
C7: Gold standard
(cefotetan,
cefoxitin, doxycycline,
oral
neomycin/
erythromycinbase).
28 trials
Surgical wound infection
1. Favour antibiotic prophylaxis
vs no antibiotics
RR=0.30 (95% CI 0.22–0.41).
2. Single dose vs multiple
doses RR=1.06 (95% CI
0.88–1.27)
3. Favour additional aerobic
cover RR=0.41 (95% CI
0.23–0.71)
4. Favour additional
anaerobic cover RR=0.55
(95% CI 0.35–0.85)
5. Favour combined nonabsorbable
oral and iv
therapy vs iv therapy
RR=0.55 (95% CI
0.41–0.74)
6. Favour combined
non-absorbable oral and iv
therapy vs non-absorbable
oral therapy RR=0.34
(95% CI 0.134–0.87)
7. Different antibiotic
vs gold standard
RR=0 (95% CI 0.0–0.0)
High
Cochrane analysis
with high quality.
The quality of
studies improved
over the years.
Studies in all
language were
considered
(161 in english)
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