Antibiotikaprofylax vid kirurgiska ingrepp - SBU

Table 4.1.4 continued
Author
Year
Reference
Country
Study
design
Population
characteristics
Intervention
Method
Number individuals
Control
Number
indiviuduals
Results
Withdrawal
Drop outs
Study quality
and relevance
Comments
Choudhary
2008
[65]
USA
Metaanalysis
RCT on prophylactic
ab in LC 133 articles
to start. 9 RCT included.
n=1 437.
3 studies were double
blinded. Single centres
I: Cefazolin, cefotaxime/
cefuroxime, cefotetan
or cefotetan/cefazolin
before operation
C: Placebo Superficial wound
infections
I: 13/797 (1.6%)
C: 15/640 (2.3%)
OR 0.71 (95% CI
0.34–1.48)
ns
Major infections
(intraabdominal)
I: 2/630 (0.3%)
C: 2/486 (0.4%)
OR 1.03 (95% CI
0.25–4.20)
ns
– High
No benefit of ab in lowrisk
patients. High-risk
pts: >60 years, diabetes
mellitus, acute colic
within 30 days, jaundice,
acute cholecystitis or
cholangitis
Distant infections
(UTI, RTI)
I: 4/499 (0.8%)
C: 6/297 (2.0%)
OR 0.49 (95% CI
0.13–1.81)
ns
Guzmán-
Valdivia
2008
[39]
Mexico
Prospective,
comparative
study
Accidental perforation
of gallbladder during
laparoscopic cholecystectomy
with escape
of bile. 166 pts were
divided into 2 groups
at random. Follow-up
30 days
I: Cefotaxime 1 g iv during
operation + 1 g iv q 8 h
(2 doses) (n=80)
C: No antibiotics
(n=86)
Postoperative wound
or intraabdominal
infection
I: 2/80 (2.5%)
C: 3/86 (3.4%) ns
Not stated
Moderate
Spillage of gallstones,
no follow-up. Not given.
Accidental perforation
occurs in 11–20% of
operations. Ab not indicated
unless risk factors:
ASA >3, Operation time
>70 min
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