TY - JOUR
T1 - Topical Antibiotic Prophylaxis for Preventing Surgical Site Infections of Clean Wounds
T2 - A Systematic Review and Meta-Analysis
AU - Lin, Wen Li
AU - Wu, Li Min
AU - Nguyen, Thi Hoang Yen
AU - Lin, Yu Hsiu
AU - Chen, Chia Jung
AU - Huang, Wen Tsung
AU - Guo, How Ran
AU - Chen, Yu Hung
AU - Chuang, Chu Hsin
AU - Chang, Ping Chin
AU - Hung, Hui Kun
AU - Chen, Shang Hung
N1 - Publisher Copyright:
© Mary Ann Liebert, Inc.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - 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.
AB - 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.
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U2 - 10.1089/sur.2023.182
DO - 10.1089/sur.2023.182
M3 - Article
C2 - 38112687
AN - SCOPUS:85181001340
SN - 1096-2964
VL - 25
SP - 32
EP - 38
JO - Surgical Infections
JF - Surgical Infections
IS - 1
ER -