Oral Antibiotic Prophylaxis Reduces Surgical Site Infection and Anastomotic Leakage in Patients Undergoing Colorectal Cancer Surgery
| Autor: | René H. J. Otten, Geert Kazemier, Gabor S. A. Abis, Marjolein van Egmond, Simran Grewal, Hein B.A.C. Stockmann, Steven J. Oosterling, J. Reinder D. Reuvers |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
QH301-705.5 medicine.drug_class Colorectal cancer Antibiotics oral antibiotics Medicine (miscellaneous) Subgroup analysis anastomotic leakage Gastroenterology General Biochemistry Genetics and Molecular Biology surgery colorectal carcinoma Internal medicine Medicine In patient Biology (General) Antibiotic prophylaxis business.industry surgical site infection medicine.disease Confidence interval Anastomotic leakage Systematic Review business Cohort study |
| Zdroj: | Biomedicines Grewal, S, Reuvers, J R D, Abis, G S A, Otten, R H J, Kazemier, G, Stockmann, H B A C, van Egmond, M & Oosterling, S J 2021, ' Oral Antibiotic Prophylaxis Reduces Surgical Site Infection and Anastomotic Leakage in Patients Undergoing Colorectal Cancer Surgery ', Biomedicines, vol. 9, no. 9, 1184 . https://doi.org/10.3390/biomedicines9091184 Biomedicines, Vol 9, Iss 1184, p 1184 (2021) |
| ISSN: | 2227-9059 |
| DOI: | 10.3390/biomedicines9091184 |
| Popis: | Background: Surgical-site infection (SSI) and anastomotic leakage (AL) are major complications following surgical resection of colorectal carcinoma (CRC). The beneficial effect of prophylactic oral antibiotics (OABs) on AL in particular is inconsistent. We investigated the impact of OABs on AL rates and on SSI. Methods: A systematic review and meta-analysis of recent RCTs and cohort studies was performed including patients undergoing elective CRC surgery, receiving OABs with or without mechanical bowel preparation (MBP). Primary outcomes were rates of SSI and AL. Secondarily, rates of SSI and AL were compared in broad-spectrum OABs and selective OABs (selective decontamination of the digestive tract (SDD)) subgroups. Results: Eight studies (seven RCTs and one cohort study) with a total of 2497 patients were included. Oral antibiotics combined with MBP was associated with a significant reduction in SSI (RR = 0.46, 95% confidence interval (CI) 0.31–0.69), I2 = 1.03%) and AL rates (RR = 0.58, 95% CI 0.37–0.91, I2 = 0.00%), compared to MBP alone. A subgroup analysis demonstrated that SDD resulted in a significant reduction in AL rates compared to broad-spectrum OABs (RR = 0.52, 95% CI 0.30 to 0.91), I2 = 0.00%). Conclusion: OABs in addition to MBP reduces SSI and AL rates in patients undergoing elective CRC surgery and, more specifically, SDD appears to be more effective compared to broad-spectrum OABs in reducing AL. |
| Databáze: | OpenAIRE |
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