Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.5.2 Closed fractures antibiotics vs placebo/no antibiotics.
Author
Year
Reference
Country
Study design
Population
characteristics
Intervention/
Method (I)
Control (C) Results Withdrawal
Drop outs
Study quality
and relevance
Comments
Gillespie
2001
[5]
Cochrane
review, metaanalysis/systematic
review
of 22 RCT
Closed fractures of
hip or other long
bones undergoing
surgery for fixation
or replacement.
10 RCT comparing
multiple doses antibiotics
vs no ab/placebo
(961 vs 935 pts) and
7 RCT comparing a
single dose antibiotic
vs no ab/placebo
(1 130 vs 1 119 pts)
I1: Systemic antibiotics,
multiple doses (Di) cloxacillin,
methicillin, penicillin,
cefazolin, cephalotin,
cefamandole, cefotiam,
nafcillin, cefuroxime,
ceftriaxone (n=961)
I2: Single dose (n=1 130)
C1: Placebo
or no ab
(n=935)
C2: Placebo
or no ab
(n=1 119)
Deep wound infection
Ab multiple dose
reduced the risk of
infection RR 0.36
(95% CI 0.21–0.65),
single dose reduced
the risk of infection
RR 0.40 (95% CI
0.24–0.67)
Not stated
High
In general poor quality
studies. The positive
results were more pronounced
in the 2 good
quality studies
Southwell-
Keely
2004
[6]
Australia
Meta-analysis
of 16 RCT
Hip fracture surgery
10 RCT comparing
antibiotic vs no ab/
placebo
I: Systemic antibiotics:
cefotiam, cloxacillin,
nafcillin, cafazoline,
cefalotin, cefuroxime,
ceftriaxone, cefradine,
methicillin (n=1 244)
C: Placebo
or no ab
(n=1 173)
Wound infection
(deep and superficial)
I: 67/1 244 (5.39%)
C: 122/1 173 (10.40%)
p=0,008
OR 0.55 (CI 0.35–0.85)
Not stated
High
The 3 RCT with highest
quality score showed
more pronounced effect
(95% CI 0.26–0.78)
Ab = Antibiotics; C = Control group; CI = Confidence interval; I = Intervention group;
pts = Patients; RCT = Randomised controlled trial; RR = Relative risk
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