Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.6.3 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
Platt
1993
[8]
USA
Metaanalysis
2 587 patients going through
breast surgery between
1985–1987 (mastectomy 45%,
lumpectomy 41%, biopsy/
axillay node dissection 4%).
606 patients were randomised,
1 981 patients not randomised.
266 reduction
mammaplasty (10%).
Surgery time 100 min.
Follow-up up to 15 days
post-op
I: Cefonicid 1 g or
cefazolin 1 g given as
perioperative antibiotic
on the day of surgery
before the end of the
procedure.
1 141 patients had
prophylaxis
C: Placebo –
1 446 pts had
no prophylaxis
Wound infection
I: 5/217 patients
(2.3%).
C: 6/49 patients
(12.2%)
RR 0.62 (95% CI
0.40–0.95; p=0.03)
adjusted for procedure
and duration of surgery
Comparison of wound
infection in randomised
and non-randomised
patients
I: Randomised
1/18 (5.6%)
wound infection
Non-randomised
4/199 (2.0%)
wound infection
C: Randomised
4/14 (28.6%)
wound infection
Non-randomised
2/35 (5.7%)
wound infection
Well described
inclusion
criteria for the
randomised
study
Moderate
Total wound infection
rate 98/2 587 patients,
3.7%. Reduction
mammaplasty 4.1%
wound infections
Tejirian
2006
[17]
USA
Systematic
review,
Metaanalysis
Breast surgery, >18 years.
benign 15%; malign 85%.
Clean surgery.
n=1 307
Follow-up within 10 days
to 6 weeks
I: Pre-op antibiotics
or re-op antibiotics
+ post-op antibiotics
(n=648)
C: Placebo (n=659) Wound infection
I: 60/659 (9.3%)
C: 102/659 (15.5%)
RR 0.60 (95% CI
0.45–0.81)
p