Antibiotikaprofylax vid kirurgiska ingrepp - SBU

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Table 4.14.8 Low quality and relevance. Author Year Reference Country Study design Population characteristics Study quality and relevance Comments Abubaker 2001 [31] USA RCT 38 pts with mandibular fractures, 8 pts were excluded Study underpowered. Power not estimated. 21% drop outs after randomisation. In review by Andresen [25] Abu-Ta’a 2008 [23] Belgium RCT 80 consecutive pts treated with dental implants. Randomised to prophylactic or no prophylactic antibiotic Included in Esposito 2008 (Cochrane) [1]. Open study. Power not estimated. Probably underpowered Aderholt 1983 [32] Germany RCT 120 pts with mandibular fractures that needed plate osteosynthesis, randomised to short or long term antibiotic prophylaxis or controls Different antibiotics. Open study. No placebo. Power not estimated. In review by Andresen [25] Bentley 1999 [18] Canada 30 pts underwent orthognathic surgery and were randomised to short term or long term antibiotic prophylaxis. Placebo controlled Low internal validity 15 pts. 2 million units penicillin G iv + 1 million units/3rd h peroperatively + 1 million units 3 h postoperatively + 1 million units penicillin G/6 h x 8 + penicillin V 300 mg orally/6 h x 8 Binahmed 2005 [33] Canada CT 125 pts (445 implants) + 90 pts (302 implants) treated with dental implants, with short term or long term antibiotic prophylaxis Not randomised. Open study. No power estimated The table continues on the next page 552 antibiotikaprofylax vid kirurgiska ingrepp
Table 4.14.8 continued Author Year Reference Country Study design Population characteristics Study quality and relevance Comments Dent 1997 [34] USA CT Unknown number of pts treated with dental implants. Multicenter study No randomisation. Control groups constructed after trial was finished. Lots of antibiotics used in different doses. Multicentric. Inconclusive study Fridrich 1994 [35] USA RCT 30 pts underwent orthognathic surgery and were randomised to short term or 1 week antibiotic prophylaxis in an open study Open study. No placebo. Power not estimated. Underpowered study Gynther 1998 [36] Sweden CT 147+132 pts treated with implants with or without antibiotic psophylaxis. Retrospective and from different time periods Retrospective. Power not estimated Heit 1997 [37] USA RCT 90 pts with mandibular fractures randomised to receive penicillin G or ceftriaxone Power not estimated, no placebo, number of pts in each group not given, single-blinded study. In review by Andresen [25] Hotz 1994 [38] Germany RCT 100 pts (42 female/ 58 male) were treated with elective maxillofacial surgery Open study. Underpowered. No untreated controls Kashani 2005 [39] Sweden CT Retrospective. All (868 pts, consecutive) pts (19970101–20001231) treated with surgical installation of dental implants Retrospective. Power not estimated The table continues on the next page KAPITEL 4 • den systematiska litteraturöversikten 553
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Antibiotikaprofylax vid kirurgiska
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Antibiotikaprofylax vid kirurgiska
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3. Antibiotikaprofylax - praxis 57
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Har antibiotikaimpregnerade grafter
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Resultat av litteratursökningen oc
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4.11 Sluten inläggning av thoraxdr
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5. Infektionsprofylax utan antibiot
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SBU:s sammanfattning och slutsatser
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Bakgrund och syfte Antibiotika i pr
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arhet. Kvalitetsgranskningen av de
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Det vetenskapliga underlaget saknas
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tagning av livmoder (måttligt star
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Bröstcancerkirurgi • Vid bröstc
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sårinfektion, empyem (varansamling
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• Antibiotikaprofylax vid öppen
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Infektiös endokardit Infektiös en
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• Endovaskulära ingrepp, speciel
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1.2 Avgränsningar Projektet omfatt
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Tabell 1.1 Effektmått förutom pos
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Tabell 1.2 fortsättning Antal bakt
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Proteinbindning Många antibiotika
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Till allmänna faktorer räknas ock
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2. Metodik för systematisk littera
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Figur 2.1 Granskningsprocessen. Fas
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Evidensstyrkan graderades i fyra ni
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3. Antibiotikaprofylax - praxis KAP
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3.1 Praxisundersökning om användn
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100 90 80 70 Procent Ja-svar 60 50
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De 37 kliniker som uppgav att de re
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Urologi Samtliga 13 kliniker som be
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Tabell 3.1.2 Finns skriftliga anvis
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72 antibiotikaprofylax vid kirurgis
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esistens). STRAMA-gruppen har delat
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Tabell 3.2.2 fortsättning Preparat
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Tabell 3.2.2 fortsättning Preparat
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4. Den systematiska litteraturöver
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4.1 Antibiotikaprofylax vid gastroi
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• Blindtarmsinflammation: Antibio
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Frågeställningar • Vilken typ a
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Weber och medarbetare publicerade 2
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Accidentell perforation under opera
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Ventrikelkirurgi (Tabell 4.1.10) Ba
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Det finns idag inga RCT av antibiot
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Table 4.1.3 Timing. Author Year Ref
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Table 4.1.4 continued Author Year R
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Table 4.1.6 ERCP. Author Year Refer
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Table 4.1.9 Oesophagus. Author Year
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Table 4.1.10 continued Author Year
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Table 4.1.12 Hernia repair. Author
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Table 4.1.13 Appendectomy. Author Y
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Referenser 1. Bai Y, Gao F, Gao J,
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laxis during elective upper gastroi
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57. Sanchez-Manuel FJ, Lozano Garci
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152 antibiotikaprofylax vid kirurgi
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• De flesta studier har jämfört
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Frågeställningar • Vilken antib
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(RR = 0,41; 95 procent KI = 0,23-0,
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Diskussion Idag använder 67 procen
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Table 4.2.2 Elective colorectal sur
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Table 4.2.3 Elective colorectal sur
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mycin as antibiotic prophylaxis in
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Bakgrund Infektioner hos patienter
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Beskrivning av studier och resultat
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Table 4.3.2 Vascular surgery. Autho
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Table 4.3.3 Low study quality and r
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Referenser 1. Christenson JT, Eklof
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a randomized, prospective trial. So
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Elektivt sectio (generellt) • Ant
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Transcervikala intrauterina ingrepp
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Vid bakteriell vaginos som kan vara
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endometrit (1 procent vs 5 procent)
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[4]. Inga av de förhållandevis f
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frekvens av infektioner efter profy
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Det finns inga data som visar att f
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Sterilisering I en stor studie frå
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Table 4.4.2 Caesarean section, anti
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Table 4.4.3 Caesarean section, comp
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Table 4.4.5 Caesarean section, mult
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Table 4.4.8 Hysterectomy, antibioti
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Table 4.4.10 Hysterectomy, duration
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Table 4.4.14 Intrauterine contracep
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15. Sullivan SA, Smith T, Chang E,
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hysterectomy. Clin Infect Dis 1995;
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urethropexy. Journal of Pelvic Medi
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97. Mangioni C, Bianchi L, Bolis PF
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4.5 Antibiotikaprofylax vid ortoped
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inte sällan i kronisk form. Insät
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Inklusionskriterier Enbart prospekt
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och medarbetare från år 1987 [9]
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(från 1998) samtidigt som man helt
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KAPITEL 4 • den systematiska litt
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Thomsen 1990 [44] Denmark RCT, open
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Table 4.5.3 Closed fractures; durat
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Table 4.5.5 Studies comparing diffe
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Table 4.5.7 Prosthesis, different d
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Table 4.5.9 Prosthesis and antibiot
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Table 4.5.11 Low study quality and
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prophylaxis in trochanteric hip fra
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45. Nungu KS, Olerud C, Rehnberg L,
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Det är oklart om antibiotikaprofyl
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Två artiklar med medelhög kvalite
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Övrig plastikkirurgi Två artiklar
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Table 4.6.2 Skin surgery. Author Ye
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Table 4.6.3 Breast surgery. Author
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Table 4.6.4 Abdominoplasty. Author
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Referenser 1. Amland PF, Andenaes K
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I en del situationer görs en omede
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Bröstcancerbehandling har genomgå
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Table 4.7.2 Breast cancer operation
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4.8 Antibiotikaprofylax vid hjärtk
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Det finns flera för hjärtkirurgi
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Bakteriologi/bakteriologisk miljö
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Alternativ till antibiotikaprofylax
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Preparatval (Tabell 4.8.3) Det stor
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av dessa studier för få patienter
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studier av effektivitet och resiste
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Table 4.8.3 Choice of antibiotics.
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Table 4.8.5 Alternatives to intrave
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14. Kadurugamuwa JL, Beveridge TJ.
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infections after cardiac surgery: a
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4.9 Antibiotikaprofylax vid implant
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KAPITEL 4 • den systematiska litt
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4.10 Antibiotikaprofylax vid allmä
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tionstekniken har även ändrats se
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penicillin och ett dygns cefuroxim
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etiologi som uppkomstmekanism. Dett
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Referenser 1. Aznar R, Mateu M, Mir
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Tabell 4.11.1 Antibiotikaprofylax j
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medelhög kvalitet. Fyra av de ing
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av hemothorax har vidare angivits s
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Table 4.11.1 Penetrating injuries o
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Referenser 1. Fallon WF, Jr, Wears
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• Stötvågsbehandling av njurste
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ersatt den öppna kirurgin för van
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är fastställd. I en undersökning
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0 och 5,1 procent hos patienter uta
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Här följer några exempel: Abdomi
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infektion. Det finns i de redovisad
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Table 4.12.3 Cystoscopy. Author Yea
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Table 4.12.4 Transrectal prostatic
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Table 4.12.6 Transurethral resectio
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Table 4.12.8 Extracorporeal Shockwa
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Table 4.12.10 Percutaneous nephroli
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Table 4.12.12 Low study quality and
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Referenser 1. Berry A, Barratt A. P
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Page 372 and 373: • Det vetenskapliga underlaget f
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Page 382 and 383: Typ av antibiotika och dos varierad
Page 384 and 385: Table 4.13.3 Tonsillectomy. Author
Page 386 and 387: Table 4.13.5 Cancer. Author Year Re
Page 388 and 389: Table 4.13.5 continued Author Year
Page 390 and 391: Table 4.13.6 Rhinosurgery. Author Y
Page 392 and 393: Table 4.13.9 Low study quality and
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Page 400 and 401: Frågeställningar • Vid vilka ki
Page 402 and 403: Anomalikirurgi (Tabell 4.14.3) Anom
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Page 408 and 409: Table 4.14.2 Third molar surgery. A
Page 410 and 411: Table 4.14.3 Orthognatic surgery. A
Page 412 and 413: Table 4.14.4 Implant surgery. Autho
Page 414 and 415: Table 4.14.6 Other dentoalveolar su
Page 418 and 419: Table 4.14.8 continued Author Year
Page 420 and 421: Referenser 1. Esposito M, Grusovin
Page 422 and 423: preoperative single-dose clindamyci
Page 426 and 427: • Sjukvården får kostnader för
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Page 430 and 431: Table 4.15.1 Antibiotic prophylaxis
Page 432 and 433: Table 4.15.2 Antibiotic prophylaxis
Page 434 and 435: 5. Infektionsprofylax utan antibiot
Page 436 and 437: frekvensen postoperativa sårinfekt
Page 438 and 439: 6. Etiska aspekter Infektioner rela
Page 440 and 441: komplikation roll. Vissa komplikati
Page 442 and 443: • Hur garanterades bästa möjlig
Page 444 and 445: Etisk analys med hjälp av aktörsm
Page 446: Referens 1. Hermerén G. Kunskapens
Page 449 and 450: Granskningen av hälsoekonomisk lit
Page 451 and 452: Distala Duodenum E Coli ”Efficien
Page 453 and 454: KNS Kolecystektomi Kolecystit Koled
Page 455 and 456: Preoperativa Protesendokoardit Pseu
Page 458 and 459: 9. Projektgrupp, externa granskare,
Page 460 and 461: Adjungerade Mats Bergström Läkare
Page 462 and 463: Principal Investigator för Sepsiss
Page 464 and 465: Därutöver konsult/rådgivningsarv
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Rapporter publicerade av SBU Gula r
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Självtestning och egenvård vid an
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