Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.4.3 Caesarean section, comparison of different antibiotics.
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Hopkins
1999
[3]
Systematic
review
Metaanalysis
CS, elective and
non-elective,
51 trials.
n=10 096
6 comparisons:
I1: Ampicillin vs cephalosporin
1st generation
I2: Ampicillin vs 2nd/3rd
generation cephalosporin
I3: 1st generation cephalosporin
vs 2nd/3rd generation
I4: Multiple dose antibiotics
vs single dose
I5: Systemic vs lavage admission
I6: Timing, early vs late admission
Endometritis
I1: No sign difference,
OR 1.27 (95% CI
0.84–1.93)
I2: No sign difference,
OR 0,83 (95% CI 0.54–1.26)
I3: No sign difference,
OR 1.21 (95% CI
0.97–1.51)
High
Study quality
overall excellent
according to
authors
I4: No sign difference,
OR 0.92 (95% CI
0.70–1.23)
I5: No sign difference,
OR 1.19 (95% CI 0.81–1.73)
I6: Insufficient evidence
Spinnato
2000
[78]
USA
RCT
CS, elective and
non-elective.
n=298
I1: Ampicillin/sulbactam 3 g
iv after umbilical cord clamp
(n=101)
I2: Cefotetan 2 g (n=96)
C: Ampicillin
2 g (n=101)
Endometritis
I1: 4/101 (4.2%)
I2: 4/96 (4.2%)
C: 6/101 (5.9%) ns
3 Moderate
Low external
validity, underpowered
C = Control group; CI = Confidence interval; CS = Caesarean section; I = Intervention
group; iv = Intravenous; n = Number of patients; ns = Non significant; OR = Odds ratio;
RCT = Randomised controlled trial; RR = Risk ratio
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