Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.4.6 Caesarean section, timing.
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
Caesarean section,
elective and nonelective,
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)
I4: No sign difference,
OR 0.92 (95% CI 0.70–1.23)
High
Study quality overall
excellent according
to authors
I5: No sign difference,
OR 1.19 (95% CI 0.81–1.73)
I6: Insufficient evidence
Sullivan
2007
[15]
USA
RCT
Caesarean section,
elective and nonelective,
high-risk
patients.
n=357
I: Preoperatively administration
of antibiotics 1 g cefazolin prior
to incision
C: Antibiotics
at cord clamp
1 g cefazolin
Total postcaesarean
infectious morbidity
I: 8/175 (4.5%)
C: 21/182 (11.5%)
OR: 0.35 (95% CI 0.14–0.82)
Endometritis
I: 2 (1%)
C: 10 (5%)
OR 0.22 (95% CI 0.05–0.9)
0 Moderate
Low external validity.
High internal
validity. Ok precision.
Side effects:
No adverse events
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