Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.1.13 Appendectomy.
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Andersen
2005
[4]
Denmark
Cochrane
review
Metaanalysis
45 studies including
9 576 pts
with appendicitis
MZ: 500 mg during op or supp 1 g 1 h
before op + 1 g q 8 h for 7 days or supp
1 g pre-op + q 8 h for 3 days + cotrimoxazole
2 mL im pre-op and q 12 h
for 3 days or 500 mg iv pre-op and q
8 h for 3 days or 1 g supp pre-op or 1 g
supp pre-op and q 8 h for 3 days.
PCG 400 000 IU/kg + chloramphenicol
50 mg/kg during op and for 24 h
Piperacillin 200 mg/kg pre-op.
Cefazolin 500 mg iv pre-op and q
8 h x 4.
Trimethoprim 240 mg + sulfametazole
1 200 mg + MZ 1.5 g iv pre-op
Trobramycin 1.5 mg + lincomycin
600 mg iv pre-op.
Gentamicin 4 mg/kg + clindamycin
15 mg/kg during op and q 8 h for 24 or
72 h or 80 mg iv during operation with
or without clindamycin 600 mg iv during
operation.
Clindamycin 600 mg iv pre-op.
Ceftizoxime or cefamandole iv
pre-op + 6–12 h post-op.
Cefamandole 2 g + carbenicillin 3 g
iv pre-op q 6 h for 24 h or alone as
above.
Cotrimaxozole 2 mL iv pre-op and
q 12 h for 3 days.
Cefazolin 1 g iv pre-op.
Cephaloridine 50 mg/kg iv pre-op
and q 6 h for 2 days.
Providone iodine locally.
Tinidazole 400 mg locally
Placebo
Wound infection
Intraabdominal abscess
Length of stay
Mortality
The use of ab is
superior to placebo
for preventing wound
infection and intraabdominal
abscess
High
No difference if given
pre-, per- or postoperatively.
No difference
if single or
multiple drugs are
used. No difference if
simple or complicated
appendicitis
ab = Antibiotics; h = Hours; im = Intramuscular; iv = Intravenous; MZ = Metronidazole;
PCG = Penicillin G; pts = Patients; q = Every; supp = Suppository
142 antibiotikaprofylax vid kirurgiska ingrepp KAPITEL 4 • den systematiska litteraturöversikten
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