Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.13.5 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
Righi
1996
[8]
Italy
RCT
Cancer of the oral
cavity, pharynx or
larynx.
n=174 enrolled
(n=162, 20 female,
142 men)
I: Clindamycin 600 mg iv followed
by 3 doses and cefonicid 1 g iv at
induction and 1 g after 12 h for
1 day (n=81)
C: Clindamycin 600 mg
iv followed by 3 doses
and cefonicid 1 g iv at
induction and 1 g after
12 h for 3 days (n=81)
Wound infections
I: 2 (5%)
C: 3 (7%)
p>0.05
12 excluded Moderate
Excluded.
Blinding not described
those who recieved
antibiotics prior to
surgery and suspected
hypersensitivity
Robbins
1988
[10]
USA
RCT
Double
blind
Oncologic contaminated
and cleancontaminated
procedures
of the head and
neck, clean procedures
that involved extensive
exposure of the operating
field or the use of
skin grafts or flaps.
n=381
I: Cefazolin 1 g iv 1 h pre-operatively
+ 500 mg iv every 8 h x 6,
metronidazole 500 mg iv 1 h
pre-operatively and 250 mg iv
every 8 h for 6 doses (n=158)
C: Cefazolin 1 g iv 1 h
pre-operatively + 500 mg
iv every 8 h x 6 (n=172)
Wound infections
I: 34 (9.5%)
C: 65 (18.6%)
p=0.03
51 Moderate
Rodrigo
1997
[11]
Spain
RCT
Double
blind
Oncologic surgery
involving a cleancontaminated
wound
Female/male: 4/155
Mean age: 59.5 years.
n=175
I1: Amoxicillin-clavulanate 2 g
iv started before surgery and
additional 3 doses (n=57)
I2: Clindamycin 600 mg +
gentamicin 80 mg started
before surgery and additional
3 doses (n=52)
C: Cefazolin 2 g started
before surgery and
additional 3 doses
of 1 g (n=50)
Wound infections
I1: 22.8%
I2: 21.2%
C: 26%
p=0.8
16 Moderate
Excluded allergic,
recent antibiotics,
and those with flap
reconstruction. High
infection rates overall,
23%. 159 pts considered
evaluable
Swanson
1991
[12]
USA
RCT
Double
blind
Major oncologic head
and neck surgery
during which a cervical
skin incision was used
to remove a tumor
of the upper aero
digestive tract, completed
within 6 h.
n=108
I: Clindamycin 600 mg iv given
1–2 h before surgery and continued
every 8 h for a total of
4 doses (n=49)
C: Cefonicid 1 g given
1–2 h pre-operatively
following placebo every
8 h for a total of 4 doses
(n=50)
Wound infections
I: 4 (8.2%)
C: 12 (24%)
p