Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.1.12 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
Kuzu
2005
[62]
Turkey
RCT
Open prosthetic hernia
repair. Compare oral and
parental administration
Power calculation. Block
randomisation. Blinded.
Defined SSI.
n=480
I1: Oral amoxicillin
+ clavulanic acid 2 h
before operation, 1.094 g
amoxicillin and 219 mg
clavulanic acid (n=240)
I2: Amoxicillin + 200 mg
clavulanic acid 1 g iv
30 min before skin
incision (n=240)
SSI, superficial
I1: 1 pt (0.5%)
I2: 3 pts (1.5%)
No deep infection
in any group
72 pts
protocol
violation
High
Oral ab more effective,
less costs
Perez
2005
[71]
The Philippines
RCT
Pre-op ab prophylaxis
in elective hernia prosthetic
repair. Computergenerated
randomisation.
Senior residents or consultants
blinded. Defined
SSI. Power calculation.
n=360
Follow-up 4 weeks
I: Cefazolin 1 g iv before
incision (n=180)
C: Placebo
(n=180)
Wound infection
I: 4/180
C: 7/180
10 pts lost
to follow-up
High
No benefit of prophylaxis.
In meta-analysis [3,57]
Platt
1990
[56]
USA
RCT
Multicenter
Elective hernia repair.
Blinded. Power calculation.
No net. Defined SSI. Mixed
with breast surgery pts.
Follow-up 12 weeks
I: Cefonicid 1 g 90 min
before surgery (n=301)
C:Placebo
(n=311)
Wound infection
I: 7/301
C: 13/311
The authors calculate
that prophylaxis
would prevent 13
wound infections per
1 000 pts
Mixed with
breast surgery
101/1 319
High
Breast cancer and hernia
repair in the same study
Authors conclude ab prophylaxis
of value, which
can be questioned in view
of low complication rate.
In meta-analysis [57]
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