Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery : A Systematic Review and Meta-Analysis

Show full item record



Permalink

http://hdl.handle.net/10138/327680

Citation

Vander Poorten , V , Uyttebroek , S , Robbins , K T , Rodrigo , J P , de Bree , R , Laenen , A , Saba , N F , Suarez , C , Mäkitie , A , Rinaldo , A & Ferlito , A 2020 , ' Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery : A Systematic Review and Meta-Analysis ' , Advances in Therapy , vol. 37 , no. 4 , pp. 1360-1380 . https://doi.org/10.1007/s12325-020-01269-2

Title: Perioperative Antibiotics in Clean-Contaminated Head and Neck Surgery : A Systematic Review and Meta-Analysis
Author: Vander Poorten, Vincent; Uyttebroek, Saartje; Robbins, K. Thomas; Rodrigo, Juan P.; de Bree, Remco; Laenen, Annouschka; Saba, Nabil F.; Suarez, Carlos; Mäkitie, Antti; Rinaldo, Alessandra; Ferlito, Alfio
Contributor: University of Helsinki, HUS Head and Neck Center
Date: 2020-04
Language: eng
Number of pages: 21
Belongs to series: Advances in Therapy
ISSN: 0741-238X
URI: http://hdl.handle.net/10138/327680
Abstract: BackgroundThe optimal evidence-based prophylactic antibiotic regimen for surgical site infections following major head and neck surgery remains a matter of debate.MethodsMedline, Cochrane, and Embase were searched for the current best evidence. Retrieved manuscripts were screened according to the PRISMA guidelines. Included studies dealt with patients over 18 years of age that underwent clean-contaminated head and neck surgery (P) and compared the effect of an intervention, perioperative administration of different antibiotic regimens for a variable duration (I), with control groups receiving placebo, another antibiotic regimen, or the same antibiotic for a different postoperative duration (C), on surgical site infection rate as primary outcome (O) (PICO model). A systematic review was performed, and a selected group of trials investigating a similar research question was subjected to a random-effects model meta-analysis.ResultsThirty-nine studies were included in the systematic review. Compared with placebo, cefazolin, ampicillin-sulbactam, and amoxicillin-clavulanate were the most efficient agents. Benzylpenicillin and clindamycin were clearly less effective. Fifteen studies compared short- to long-term prophylaxis; treatment for more than 48 h did not further reduce wound infections. Meta-analysis of five clinical trials including 4336 patients, where clindamycin was compared with ampicillin-sulbactam, implied an increased infection rate for clindamycin-treated patients (OR=2.73, 95% CI 1.50-4.97, p=0.001).ConclusionIn clean-contaminated head and neck surgery, cefazolin, amoxicillin-clavulanate, and ampicillin-sulbactam for 24-48 h after surgery were associated with the highest prevention rate of surgical site infection.
Subject: Evidence based
Guidelines
Head and neck oncology
Head and neck surgery
Meta-analysis
Perioperative antibiotics
Prophylaxis
Systematic review
FREE-FLAP RECONSTRUCTION
SURGICAL SITE INFECTION
ONCOLOGIC SURGERY
MAJOR HEAD
ANTIMICROBIAL PROPHYLAXIS
CLINDAMYCIN PROPHYLAXIS
SHORT-TERM
CEFAZOLIN
COMPLICATIONS
METRONIDAZOLE
317 Pharmacy
3125 Otorhinolaryngology, ophthalmology
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
VanderPoorten20 ... ativeAntibioticsInClea.pdf 755.4Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record