Effect of preoperative oral antibiotics and mechanical bowel preparation on the prevention of surgical site infection in elective colorectal surgery, and does oral antibiotic regime matter? a bayesian network meta-analysis

Koo, Chee Hoe; Chok, Aik Yong; Wee, Ian Jun Yan; Seow‐En, Isaac; Zhao, Yun; Tan, Emile

doi:10.1007/s00384-023-04444-3

Cited by 10 publications

(8 citation statements)

References 78 publications

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“…In another similar paediatric study, 16 patients with MBP combined with oral antibiotics had higher rate of postoperative complications than those who used MBP only. Subsequently, in a randomized effect model considering hospital grouping effect, MBP alone or combined with oral antibiotics did not differ significantly from those without MBP 40 . Nevertheless, Garfinkle et al 41 found that only orally antibiotics significantly reduced the rate of postoperative complications in rectal surgery, and MBP added oral antibiotics did not provide any advantage.…”

Section: Discussionmentioning

confidence: 97%

“…For example, some patients were not given any antibiotics, some were given oral antibiotics, and some were given intravenous antibiotics. Even within the same group, some studies did not report whether the patients were on antibiotics or not, which may cause confounding factors 40 . The impact of preoperative antibiotic use on postoperative complications remains controversial 41 .…”

Section: Discussionmentioning

confidence: 99%

“…Even within the same group, some studies did not report whether the patients were on antibiotics or not, which may cause confounding factors. 40 The impact of preoperative antibiotic use on postoperative complications remains controversial. 41 In an adult study, 40 comparing three groups of patients, the likelihood of surgical site infections after MBP combined with oral antibiotics was lower compared to patients who used MBP only and those who did not use MBP or oral antibiotics.…”

Section: Discussionmentioning

confidence: 99%

“… 40 The impact of preoperative antibiotic use on postoperative complications remains controversial. 41 In an adult study, 40 comparing three groups of patients, the likelihood of surgical site infections after MBP combined with oral antibiotics was lower compared to patients who used MBP only and those who did not use MBP or oral antibiotics. In another similar paediatric study, 16 patients with MBP combined with oral antibiotics had higher rate of postoperative complications than those who used MBP only.…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, in a randomized effect model considering hospital grouping effect, MBP alone or combined with oral antibiotics did not differ significantly from those without MBP. 40 Nevertheless, Garfinkle et al 41 found that only orally antibiotics significantly reduced the rate of postoperative complications in rectal surgery, and MBP added oral antibiotics did not provide any advantage. Ideally, we should have stratified the analyses according to the use of antibiotics or not; however, the included studies did not provide sufficiently detailed information.…”

Section: Discussionmentioning

confidence: 99%

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RETRACTED: The effect of preoperative mechanical bowel preparation in paediatric bowel surgery on postoperative wound related complications: A meta‐analysis

Chen,

Lin,

Miao

et al. 2024

International Wound Journal

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Mechanical bowel preparation (MBP), a routine nursing procedure before paediatric bowel surgery, is widely should in clinical practice, but its necessity remains controversial. In a systematic review and meta‐analysis, we evaluated the effect of preoperative MBP in paediatric bowel surgery on postoperative wound‐related complications in order to analyse the clinical application value of MBP in paediatric bowel surgery. As of November 2023, we searched four online databases: the Cochrane Library, Embase, PubMed, and Web of Science. Two investigators screened the collected studies against inclusion and exclusion criteria, and ROBINS‐I was used to evaluate the quality of studies. Using RevMan5.3, a meta‐analysis of the collected data was performed, and a fixed‐effect model or a random‐effect model was used to analyse OR, 95% CI, SMD, and MD. A total of 11 studies with 2556 patients were included. Most of studies had moderate‐to‐severe quality bias. The results of meta‐analysis showed no statistically significant difference in the incidence of complications related to postoperative infections in children with MBP before bowel surgery versus those with No MBP, wound infection (OR 1.11, 95% CI:0.76 ~ 1.61, p = 0.59, I2 = 5%), intra‐abdominal infection (OR 1.26, 95% CI:0.58 ~ 2.77, p = 0.56, I2 = 9%). There was no significant difference in the risk of postoperative bowel anastomotic leak (OR 1.07, 95% CI:0.68 ~ 1.68, p = 0.78, I2 = 12%), and anastomotic dehiscence (OR 1.67, 95% CI:0.13 ~ 22.20, p = 0.70, I2 = 73%). Patients' intestinal obstruction did not show an advantage of undergoing MBP preoperatively, with an incidence of intestinal obstruction (OR 1.95, 95% CI:0.55 ~ 6.93, p = 0.30, I2 = 0%). Based on existing evidence that preoperative MBP in paediatric bowel surgery did not reduce the risk of postoperative wound complications, we cautiously assume that MBP before surgery is unnecessary for children undergoing elective bowel surgery. However, due to the limited number of study participants selected for this study and the overall low quality of evidence, the results need to be interpreted with caution. It is suggested that more high quality, large‐sample, multicenter clinical trials are required to validate our findings.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%