Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of Clean Wounds: A Systematic Review and Meta-Analysis

Wen Li Lin, Li Min Wu, Thi Hoang Yen Nguyen, Yu Hsiu Lin, Chia Jung Chen, Wen Tsung Huang, How Ran Guo, Yu Hung Chen, Chu Hsin Chuang, Ping Chin Chang, Hui Kun Hung, Shang Hung Chen

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Topical antibiotic agents are not generally indicated for preventing of surgical site infections (SSIs) in clean incisions, and the drug concentrations that should be delivered to local incision sites remain uncertain. The aim of this study was to critically assess the efficacy of topical antibiotic agents in comparison with non-antibiotic agents for preventing SSIs in clean incisions by performing a systematic review and meta-analysis. Methods: We conducted a search of literature in PubMed, Embase, and Cochrane Databases and included randomized controlled trials (RCTs) on topical antibiotic use for patients with clean post-surgical incisions. The primary outcome was the incidence of SSI, presented as the event rate. Eleven RCTs were included. Results: Using random-effects modeling, the pooled risk ratio (RR) of developing a post-surgical incisions infection was 0.83 (95% confidence interval [CI], 0.61–1.16; I2, 0%). In subgroup analyses, no reductions in SSI were observed when topical antibiotic agents were used to treat incisions due to spinal (RR, 0.75; 95% CI, 0.40–1.38; I2, 0%), orthopedic (RR, 0.69; 95% CI, 0.37–1.29; I2, 0%), dermatologic (RR, 0.77; 95% CI, 0.39–1.55; I2, 65%), or cardiothoracic surgeries (RR, 1.31; 95% CI, 0.83–2.06; I2: 0%). The incidence of SSI across different operative phases did not differ for the application of topical antibiotic agents compared with non-antibiotic agents (RR, 0.80; 95% CI, 0.56–1.14; I2, 0%). Conclusions: The results of this meta-analysis show that topical antibiotic agents provide no clinical benefit for preventing SSI in clean incisions.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalSurgical Infections
Volume25
Issue number1
DOIs
Publication statusPublished - 2024 Feb 1

All Science Journal Classification (ASJC) codes

  • Surgery
  • Microbiology (medical)
  • Infectious Diseases

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