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    標題: Topical antibiotic prophylaxis for surgical wound infections in clean and clean-contaminated surgery: a systematic review and meta-analysis
    作者: Chen, Po-Jung
    Hua, Yi-Ming
    Toh, Han Siong
    Lee, Mei-Chuan
    貢獻者: Chi Mei Med Ctr, Dept Emergency Med
    Chi Mei Med Ctr, Dept Pharm
    Chi Mei Med Ctr, Dept Intens Care Med
    Natl Cheng Kung Univ, Coll Med, Inst Clin Med
    Chia Nan Univ Pharm & Sci, Dept Hlth & Nutr
    Natl Cheng Kung Univ, Coll Med, Dept Publ Hlth
    關鍵字: SITE INFECTION
    STAPHYLOCOCCUS-AUREUS
    NASAL CARRIERS
    PREVENTION
    GUIDELINE
    OINTMENT
    IMPACT
    CARRIAGE
    RATES
    日期: 2021
    上傳時間: 2023-11-11 11:44:18 (UTC+8)
    出版者: OXFORD UNIV PRESS
    摘要: Our results indicate that topical antibiotics did not have a benefit in reducing surgical site infections (SSIs). In addition, topical antibiotics did not result in any reduction in SSIs in different types or different phases of surgery. Background Topical antibiotics are widely prescribed as prophylaxis for surgical site infection (SSI). Despite giving high drug concentrations at local wound sites, their efficacy remains controversial. This study is a systematic review and meta-analysis designed to compare the efficacy and safety of topical antibiotics with non-antibiotic agents in preventing SSI. Methods Randomized controlled trials (RCTs) comparing topical antibiotics in patients with clean and clean-contaminated postsurgical wounds were included. Relevant trials published before 30 September 2020, were searched in the PubMed, Embase, and Cochrane databases, without language restrictions. The primary outcome was the incidence of SSIs, presented as the event rate. The secondary outcome was the incidence of contact dermatitis (safety outcome). Data were synthesized using the random-effects model, with the results expressed as risk ratio (RR) with 95 per cent confidence intervals (c.i.). Results Thirteen RCTs were included. The incidence of SSIs and contact dermatitis showed no significant difference between topical antibiotics and non-antibiotic agents (RR 0.89, 95 per cent c.i. 0.59 to 1.32 (P = 0.56, I-2 = 48 per cent); and RR 2.79, 95 per cent c.i. 0.51 to 15.19 (P = 0.24, I-2 = 0 per cent), respectively). In the subgroup analyses, a reduction in SSIs was also not observed in dermatological (RR 0.77, 95 per cent c.i. 0.39 to 1.55; P = 0.46, I-2 = 65 per cent), ocular (RR 0.08, 95 per cent c.i. 0.00 to 1.52; P = 0.09), spinal (RR 1.34, 95 per cent c.i. 0.65 to 2.77; P = 0.43, I-2 = 0 per cent), orthopaedic (RR 0.69, 95 per cent c.i. 0.37 to 1.29; P = 0.25, I-2 = 0 per cent), or cardiothoracic surgeries (RR 1.60, 95 per cent c.i. 0.79 to 3.25; P = 0.19). Conclusion Given the current evidence, the routine application of topical antibiotics to surgical wounds did not reduce the incidence of SSI. Further trials are needed to assess their effectiveness in high-risk surgeries or in selected patient groups.
    關聯: BJS OPEN, v.5, n.6, zrab125
    顯示於類別:[保健營養系(所) ] 期刊論文

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