Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.1.10 continued
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Stone
1977
[44]
USA
RCT
Consecutive pts with GIsurgery.
Randomised.
Blinded. Defined SSI.
Follow-up not given.
Different ab regimens
vs placebo.
n=106
I1: Cefazolin 1 g 12 h before
operation (n=25) + 2 times
operation day (n=24)
I2: Cefazolin 1 g just prior
to operation + 2 times after
operation (n=30)
I3: Cefazolin 1 g just after
operation + day 1 two times
(n=27)
C: Placebo (n=25) Intraabdominal
infection
I1: 1 pt (4%)
I2: 1 pt (3%)
I3: 5 pts (19%)
C: 2 pts (8%)
Wound infection
I1: 1 pt (4%)
I2: 7 pts (7%)
I3: 19 pts (5%)
C: 16 pts (24%)
Not stated
Moderate
Well controlled. Low
incidence in control
patients. Ab should
be given prior to
operation
Svaninger
1987
[53]
Sweden
RCT
High-risk gastric surgery:
malignancy, bleeding
or second operation,
obstruction. Compare
two prophylaxes. Defined
SSI. One ward, Sealed
envelopes.
n=199
Follow-up 4 weeks
I1: Cefuroxime 1.5 g iv at
induction of anestheasia
and 8 h later (n=101)
I2: Doxycycline iv 400 mg
at induction of anesthesia
(n=98)
Abdominal +
wound infection
I1: 6/101 (6%)
I2: 5/98 (5%)
Chest infection
I1: 21/101 (20%)
I2: 20/98 (20%)
0 Moderate
Equally effective.
Higher pH in stomach
tended to give more
chest infections, but
not all pts studied for
occurrence of bacteria
ab = Antibiotics; C = Control group; CT = Controlled trial; GI = Gastrointestinal;
I = Intervention group; iv = Intravenous; n = Number of patients; po = Per os;
RCT = Randomised controlled trial; SSI = Surgical site infection
130 antibiotikaprofylax vid kirurgiska ingrepp KAPITEL 4 • den systematiska litteraturöversikten
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