Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.8.3 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
Kreter
1992
[1]
Canada
Metaanalysis
Cardio-thoracic operations
Total 28 studies
6 759 pts; prospective
design, randomised
Comparisons
1. 6 studies (n=966)
2. 6 studies (cephradine
vs cefamandole 1 study)
3. 6 studies (n=2 630),
data were combined
from both cefamandole
and cefuroxime
4. 2 studies (n=629)
5. 3 studies (n=1 515)
6. 1 study (n=99)
7. 1 study (n=263)
8. 1 study (n=512)
9. 1 study
10. 1 study
I1: Cephalosporin
I2: Cephalothin or cephradine
I3: Cefazolin
I4: Cefamandole
I5: Cefazolin
I6: Cephalotin
I7: Cephalotin
I8: Cefuroxime
I9: Cefazolin + gentamicin
I10: Penicillin G
I11: Teicoplanin 2 dosage
regimens
C1: Antistaphylococcal
penicillin
C2: Cefamandole
+ ceforanide
C3: Cefamandole
or cefafuroxim
C4: Cefuroxime
C5: Ceftriaxone
C6: Cefazolin
C7: Clindamycin
C8: Ceftriaxone
C9: Cefamandole
+ gentamicin
C10: Vancomycin
C11: Flucloxacillin
+ gentamicin
Total SSI stenal wound
+ sapenous vein donor
site infection
1. OR 0.51
(95% CI 0.23–1.02)
2. OR; 1.28
(95% CI 0.68–2.43)
3. OR 1.58
(95% CI 1.03–2.45)
4. OR 1.58
(95% CI 0.51–5.35)
5. OR 0.44
(95% CI 0.16–1.11)
6. 2% in both treatment
groups
7. Trend for reduction
in SSI with clindamycin
8. 1.2% in both treatment
groups
9. Significant reduction
SSI with cefamandole/
gentamicin
Moderate
Authors own
conclusions;
Limitations;
lack of power,
stratification of
pts according to
emergency or
type of procedure
lacking,
variations in
definitions
of outcome
(infection),
removal from
consideration
after randomisation
varied
0–31%, doses
of antibiotics
used were
justified by
pharmacokinetic
studies
in some cases,
but seemed
unusually low
in others
11. 1 study (n=517)
10. Significant reduction
SSI with vancomycin
11. High sternal wound
infection rate in teicoplanin
group (21.5–28.0%), also
in flucloxacillin + getamicin
groups (10.3–17.2%)
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