Meta-analysis on Surgical Infections

Matthaiou, Dimitrios K.; Peppas, George; Falagas, Matthew E.

doi:10.1016/j.idc.2009.01.012

Cited by 10 publications

(6 citation statements)

References 118 publications

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“…Clinical studies and meta-analyses provided evidence for each measure in this model (20). A consistent relationship between timing of antimicrobial administration preoperatively and SSI risk has been shown by Classen et al and Steinberg et al (6,29).…”

Section: Discussionsupporting

confidence: 62%

Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Young

Teng

et al. 2011

Antimicrob Agents Chemother

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Surgical site infection (SSI) is a common and preventable complication of surgery, but the relative importance of individual measures recommended by guidelines has not been determined. Elective general surgical, neurological, and orthopedic procedures requiring antibiotic prophylaxis from a 3-month period were retrospectively studied to determine concordance with SSI prevention guidelines and to identify factors which predicted the development of SSIs. A total of 216 surgeries were reviewed, with 18 SSIs (8.3%). A mean of 1.4 antibiotic prophylaxis errors per surgery were identified, with correct antibiotic type identified for 64%, antibiotic timing for 83%, supplemental antibiotic dosing for 34%, and antibiotic duration of less than 24 h for 44%. Normothermia was present in 79% of surgeries, and normoglycemia was present in 17%. Univariate analysis of the SSI rate identified four significant factors. National and international surveillance programs (9, 33) and numerous guidelines (1-3, 11, 19, 24, 26) have been developed to prevent surgical site infection (SSI), the most common nosocomial infection in postsurgery patients. These guidelines emphasize the role of appropriate evidence-based antibiotic prophylaxis, hair removal by clipping as needed (31), avoidance of hypothermia (except in cardiac surgery) (16), and normoglycemia for diabetic patients (17) to reduce SSI rates.A recent pilot project at our institution prior to the current study demonstrated that implementation of such guidelines can be successful locally, but compliance elsewhere has been shown to be poor (4, 18). Furthermore, there is a high prevalence of multidrug-resistant bacteria in Singapore hospitals, and inappropriate antibiotic use, including for SSI prophylaxis, can aggravate the selective pressure for antimicrobial resistance (15).We evaluated SSI prevention practiced in our hospital to assess concordance with published international evidencebased SSI prevention guidelines and the effects of failure to comply with subsequent SSI rates.

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Section: Discussionsupporting

confidence: 62%

Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Young

Teng

et al. 2011

Antimicrob Agents Chemother

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“…However, major complications, including small bowel obstruction, wound rupture and postoperative cardiac problems, were mainly observed in the appendicectomy group, while minor complications, including diarrhea and fungal infection, existed primarily in the antibiotic group (31,32). Therefore, antibiotic therapy is advantageous compared with appendicectomy for the treatment of acute appendicitis (33). …”

Section: Discussionmentioning

confidence: 99%

Meta-analysis of the therapeutic effects of antibiotic versus appendicectomy for the treatment of acute appendicitis

Liu

Zhang

et al. 2014

Experimental and Therapeutic Medicine

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Appendicectomy has been the gold standard treatment of acute appendicitis for more than a century, while nonoperative therapies, including antibiotics, have acquired increased interest in recent years. The present meta-analysis aimed to compare the therapeutic effects of antibiotics versus appendicectomy for the treatment of acute appendicitis. Medline, Embase and The Cochrane Library databases were searched. Prospective randomized controlled trials that compared antibiotic treatment with surgery were included. The outcomes evaluated included the time of hospital stay, complications and time to work. There were no statistically significant differences between the antibiotic and appendicectomy groups with regard to the time of hospital stay and complications. However, the time to work was significantly longer in the appendicectomy group when compared with the antibiotic group. In addition, the therapeutic effects of antibiotics and appendicectomy were comparable for the treatment of acute appendicitis.

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“…Current descriptive sectional study was conducted in 2015 to find status of using antibiotic in practice as prophylaxis and to compare with recommended national and international guidelines. Despite advices for applying PA preoperatively to prevent SSI, the concern of generation of drug-resistant bacterial organisms due to inappropriate antibiotic use is great (1)(2)(3)(4)(5)(6)(7)(8)(9). In case of having optimal use of antibiotics hence studies conducted to achieve scientific acceptable guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…Considering results of other authors show that studies performed in Australia, Brazil, Netherland and United states before the year of 2005 had relatively acceptable accommodation with ASHP guideline, though there was no complete matching and achieving this goal is not easy (2,3,9,12). Data later to 2006 shows disappointing results with proportion rate of lower than 50% of truly use of PA (2)(3)(4)(5). In national similar surveys PA prescription, apart from case of operation was compatible with guidelines from 25% to 76% (3,6).…”

Section: Discussionmentioning

confidence: 99%

“…Different prophylactic methods have been described to prevent postoperative Surgical Site Infection (SSI) (1)(2)(3)(4)(5), all aimed to reinforce host agents against enormous endogenous and exogenous bacterial colonization and following infection at sites of surgery (2,5). Although SSI prophylaxis has been accepted and very commonly considered since 20 years ago, but it is a fact that prevalence of SSI is even high.…”

Section: Introductionmentioning

confidence: 99%

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Prophylactic antibiotics prescription in ear, nose, throat and ophthalmologic procedures; an Iranian university hospital situational analysis

et al. 2018

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Introduction: Different prophylactic methods are introduced to prevent surgical site Infection. This study was conducted to evaluatesituation of prophylactic antibiotics (PA) usage in an Iranian university hospital. Aims: A cross sectional study. Methods: This study obtained data from 1010 patients' medical files in 2015. These patients were admitted to a university otolaryngology (ENT) and ophthalmology hospital in north of Iran. Data from ordered prophylactic antibiotics considering induction time, type of antibiotic, duration of use, dosage amount and intervals was obtained to compare with international and national guidelines. Data analysis was performed by using Chi-square test at significance level of 95%. Results: 402 (39.8%) patients were male and 608 (60.2%) ones were female. Mean age and standard deviation was 41.8±22.3 years old, and most participants were in 20-39 years of age. Ophthalmic and ENT related procedure was respectively conducted for 41.7% and 58.3% of patients. Septorhinoplasty and phacoemulsification were the commonest procedures. Totally 999 (98.9%) people received prophylactic antibiotics. Intravenous Cefazolin (for ENT procedures) and topical eye drop of Chloramphenicol 0.5% were prescribed mostly. We found poor accommodation between antibiotic use and guidelines for prophylaxis, mostly in case of duration of apply. Conclusion: Ordered prophylactic antibiotics is not as need as prescribed. Also, accommodation between prescription of antibiotics and available scientific guidelines was improper in this study.

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Meta-analysis on Surgical Infections

Cited by 10 publications

References 118 publications

Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Nonconcordance with Surgical Site Infection Prevention Guidelines and Rates of Surgical Site Infections for General Surgical, Neurological, and Orthopedic Procedures

Meta-analysis of the therapeutic effects of antibiotic versus appendicectomy for the treatment of acute appendicitis

Prophylactic antibiotics prescription in ear, nose, throat and ophthalmologic procedures; an Iranian university hospital situational analysis

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