Systematic review and evidence- based guidance ... - ECDC - Europa

Systematic review and evidence-based guidance on perioperative antibiotic prophylaxisTECHNICAL REPORTObjective 3: What are the obstacles that prevent the implementation of adequatePAP?Types of studies included and excluded for Objective 3:Included study types• All CBAs• Non-CBAs• Observational retrospective or prospective cohort studies, including studies with/without controlgroup and questionnaire-based studies on PAP non-compliance• Systematic reviews and meta-analysis which evaluated the primary outcomes• No restrictions regarding the year of publicationExcluded study typesNon-systematic reviewsPICO for Objective 3PopulationInterventionComparisonOutcomeAll healthcare professionals involved in administering PAP for surgical proceduresAll interventions detrimental to appropriate administration of PAPAll healthcare professionals administering PAP appropriatelyPrimary outcomes:• Barriers for implementation of appropriate PAP• Non-compliance with guidelines or bundles addressing PAP• Non-compliance with individual process measures such as indication, timing, dosage, duration of PAP• Hospital-dependent organisational or structural barriersObjective 4: Do timing, dosage or duration of PAP as process indicators have aninfluence on the incidence of SSIs?Types of studies included and excluded for Objective 4:Included study types• All CBAs• Non-CBAs• Interrupted-time-series analyses• RCTs• Observational retrospective or prospective cohort studies (if control group was reported or, in caseof risk factor analysis, if a multivariate analysis of risk factors for SSI was reported)• Systematic reviews and meta-analysis evaluating primary outcomes• No restrictions for year of the study’s publication; the majority of eligible clinical studies wereconducted before 2000Excluded study types• All studies not reportingSSI• All surveillance studies• Observational studieswithout a control• Non-systematic reviewsPICO for Objective 4PopulationAll adult and non-adult patients undergoing day, outpatient or inpatient surgery who received systemic PAPIntervention All interventions investigating selection, timing, dosage and duration of PAP administrationComparisonOutcomeSurgical procedures in which administration of PAP varied with respect to:• the selection of alternative antibiotics• premature or delayed timing of PAP• the administration of multiple doses of PAP• a longer duration of PAPPrimary outcomes were defined as:• SSI• Timing and/or dosage and/or duration of PAP• Selection according to local antimicrobial susceptibility patternObjective 5: Does the use of PAP have an effect on the incidence of CDI and thedevelopment of antimicrobial resistance?Types of studies included and excluded for Objective 5:Included study types• All CBAs• Non-CBAs• Interrupted-time-series studies• Observational retrospective or prospective cohort studies (as longas a control group was reported)• Surveillance studies (as long as a multivariate analysis of riskfactors for those outcomes was performed and included)• Systematic reviews and meta-analysis evaluating outcomes• No restriction regarding the year of publicationExcluded study types• All studies which provide neither identification norantimicrobial susceptibility testing of bacterial isolates• Observational studies not reporting a control group• Non-systematic reviews6