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Antibiotikaprofylax vid kirurgiska ingrepp - SBU

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Table 4.4.8 continued<br />

Author<br />

Year<br />

Reference<br />

Country<br />

Study<br />

design<br />

Population<br />

characteristics<br />

Intervention<br />

Method<br />

Number indi<strong>vid</strong>uals<br />

Control<br />

Number<br />

indi<strong>vid</strong>uals<br />

Results<br />

Withdrawal<br />

Drop outs<br />

Study quality<br />

and relevance<br />

Comments<br />

Costa<br />

2004<br />

[4]<br />

Brasil<br />

Systematic<br />

review<br />

Meta<br />

analysis<br />

16 studies,<br />

abdominal<br />

hysterectomy<br />

(n=2 456)<br />

I: Antibiotics C: Placebo Infections<br />

OR 0.49 (95% CI<br />

0.41–0.59)<br />

Moderate<br />

Spanish, english abstract.<br />

Broad mix of infections<br />

Duff<br />

1980<br />

[24]<br />

England<br />

Systematic<br />

review<br />

Vaginal hysterectomy,<br />

20 studies published<br />

1966–1977<br />

I: Antibiotics C: Placebo Infections<br />

I: 5–20%<br />

C: 40–50%<br />

Moderate<br />

One primary RCT<br />

also in [38]<br />

Houang<br />

1991<br />

[38]<br />

England<br />

Systematic<br />

review<br />

Abdominal and<br />

vaginal hysterectomy.<br />

26 studies.<br />

n=5 049<br />

7 RCT placebo<br />

controlled (n=772)<br />

I: Antibiotics C: Placebo Infections<br />

Vaginal subgroup<br />

I: 5%<br />

C: 20%<br />

Moderate<br />

Author’s conclusion<br />

regarding abdominal<br />

hysterectomy: further<br />

studies needed<br />

Mittendorf<br />

1993<br />

[26]<br />

USA<br />

Systematic<br />

review<br />

Metaanalysis<br />

Abdominal hysterectomy,<br />

25 RCT<br />

placebo controlled<br />

(cefazolin, metronidazole<br />

or tinidazole)<br />

I: n=1 836 C: n=1 768 Serious infections (SSI)<br />

I: 166/1 836 (9.0%)<br />

C: 373/1 768 (21.1%)<br />

p=0.034<br />

Cefazolin vs placebo<br />

p=0.00001<br />

Moderate<br />

Metronidazole vs placebo<br />

p=0.0002<br />

Tinidazole vs placebo<br />

p=0.015<br />

The table continues on the next page<br />

240 antibiotikaprofylax <strong>vid</strong> <strong>kirurgiska</strong> <strong>ingrepp</strong> KAPITEL 4 • den systematiska litteraturöversikten<br />

241

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