Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.13.4 Ear surgery.
Author
Year
Reference
Country
Study design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
individuals
Results outcome 1
intervention
Withdrawal
Drop outs
Study quality
and relevance
Comments
Verschuur
2004
[20]
Systematic review
Meta-analysis
Cochrane
Collaboration
11 RCT or quasi-RCT
of pts undergoing
clean or cleancontaminated
types
of ear surgery. Skull
base surgery was
excluded.
Follow-up 3 weeks
after surgery
I: Any regimen of systematic
and/or local prophylaxis
administered
at or around the time
of surgery
C: Placebo,
no antibiotic
or alternative
intervention
Postoperative infection
within 3 weeks
Systemic antibiotic
prophylaxis vs no
antibiotics (3 studies)
I: 20 pts of 172
C: 14 pts of 127
OR 1.02 (95% CI
0.49–2.15) ns
Graft failure rates
within 3 weeks
Systemic antibiotic prophylaxis
vs no antibiotics
(1 study)
I: 13 pts of 1 118)
C: 15 pts of 1 018
OR 0.79 (95% CI
0.37–1.66) ns
Postoperative infection
within 3 weeks
Systemic and/or local
antibiotic prophylaxis vs
no antibiotics (6 studies)
I: 34 pts of 671
C: 38 pts of 620
OR 0.73 (95% CI
0.45–1.20) ns
In the analyses
a “worst-case
scenario” was
followed
Moderate
The information
on blinding
was often not
provided. None
of the studies
were considererd
to contain
“fatal flaws”.
The data in the
studies were not
pretended in sufficient
detail to
make subgroup
analyses for
children and
adults, surgical
techniques, or
for the distinction
between
clean and cleancontaminated
Graft failure rates
within 3 weeks
Systemic and/or local
antibiotic orophylaxis vs
no prophylaxis (2 studies)
I: 13 pts of 1 189
C: 17 pts of 1 093
OR 0.71 (95% CI
0.35–1.45) ns
C = Control group; CI = Confidence interval; I = Intervention group; pts = Patients;
RCT = Randomised controlled trial
506 antibiotikaprofylax vid kirurgiska ingrepp KAPITEL 4 • den systematiska litteraturöversikten
507