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Meta-analysis of randomized and quasi-randomized clinical trials of topical antibiotics after primary closure for the prevention of surgical-site infection.
Heal, C F; Banks, J L; Lepper, P; Kontopantelis, E; van Driel, M L.
Afiliación
  • Heal CF; Department of General Practice and Rural Medicine, James Cook University, Mackay, Queensland, Australia.
  • Banks JL; College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
  • Lepper P; Mackay Institute of Research and Innovation, James Cook University, Mackay, Queensland, Australia.
  • Kontopantelis E; College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
  • van Driel ML; College of Medicine and Dentistry, James Cook University, Mackay, Queensland, Australia.
Br J Surg ; 104(9): 1123-1130, 2017 Aug.
Article en En | MEDLINE | ID: mdl-28656693
BACKGROUND: Surgical-site infections (SSIs) increase patient morbidity and costs. The aim was to identify and synthesize all RCTs evaluating the effect of topical antibiotics on SSI in wounds healing by primary intention. METHODS: The search included Ovid MEDLINE, Ovid Embase, the Cochrane Wounds Specialized Register, Central Register of Controlled Trials and EBSCO CINAHL from inception to May 2016. There was no restriction of language, date or setting. Two authors independently selected studies, extracted data and assessed risk of bias. When sufficient numbers of comparable trials were available, data were pooled in meta-analysis. RESULTS: Fourteen RCTs with 6466 participants met the inclusion criteria. Pooling of eight trials (5427 participants) showed that topical antibiotics probably reduced the risk of SSI compared with no topical antibiotic (risk ratio (RR) 0·61, 95 per cent c.i. 0·42 to 0·87; moderate-quality evidence), equating to 20 fewer SSIs per 1000 patients treated. Pooling of three trials (3012 participants) for risk of allergic contact dermatitis found no clear difference between antibiotics and no antibiotic (RR 3·94, 0·46 to 34·00; very low-quality evidence). Pooling of five trials (1299 participants) indicated that topical antibiotics probably reduce the risk of SSI compared with topical antiseptics (RR 0·49, 0·30 to 0·80; moderate-quality evidence); 43 fewer SSIs per 1000 patients treated. Pooling of two trials (541 participants) showed no clear difference in the risk of allergic contact dermatitis with antibiotics or antiseptic agents (RR 0·97, 0·52 to 1·82; very low-quality evidence). CONCLUSION: Topical antibiotics probably prevent SSI compared with no topical antibiotic or antiseptic. No conclusion can be drawn regarding whether they cause allergic contact dermatitis.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección de la Herida Quirúrgica / Antiinfecciosos Locales / Antibacterianos Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Br J Surg Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Infección de la Herida Quirúrgica / Antiinfecciosos Locales / Antibacterianos Tipo de estudio: Clinical_trials / Etiology_studies / Prognostic_studies / Systematic_reviews Límite: Humans Idioma: En Revista: Br J Surg Año: 2017 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Reino Unido