A Cochrane review [Abstract] 1 included 182 studies with a total of 30 880 subjects and 50 different antibiotics. Prophylactic antibiotics compared to placebo/no treatment decreased postoperative surgical wound infection (SWI) (RR 0.30, 95% CI 0.22 to 0.41; 10 studies, n=813). No statistically significant difference was observed between short- and long-term duration of prophylaxis (RR 1.06, 95% CI 0.89 to 1.27; 24 studies, n=3541), and single dose versus multiple dose antibiotics (RR 1.17, 95% CI 0.67 to 2.05; 3 studies, n=522). Additional aerobic coverage and additional anaerobic coverage both showed statistically significant improvements in SWI rates (RR 0.41, 95% CI 0.23 to 0.71; 11 studies, n=1269 and RR 0.55, 95% CI 0.35 to 0.85; 15 studies, n=2394, respectively); as did combined oral and intravenous antibiotic prophylaxis when compared to intravenous alone (RR 0.55, 95% CI 0.41 to 0.74; 13 studies, n=2362), or oral alone (RR 0.34, 95% CI 0.13 to 0.87; 3 studies, n=283). Established gold standard regimens (oral neomycin/erythromycin base, intravenous cefoxitin, intravenous and oral doxycycline) were no less effective than any other antibiotic choice.
Primary/Secondary Keywords