Shaoning Luo1, Yu Lai2, Chunxin Liu1, Yi Chen3, Xiaoyu Qiao1. 1. Emergency Department, The Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China. 2. Department of Gastroenterology, Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China. 3. Department of Breast Surgery, Sun Yat-Sen Menorial Hospital, Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
Abstract
PURPOSE: To conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (Gen/Flu) in preventing post-operative wound infections and their association with risks of Clostridium difficile infections and post-operative renal impairment. METHODS: Published studies including both prophylactic cefuroxime and prophylactic Gen/Flu used in surgery were included for meta analysis. Outcomes were analyzed using a random-effect model or a fixed-effect model depending on the heterogeneity across the included studies. RESULTS: Gen/Flu prophylaxis showed similar efficacy as cefuroxime prophylaxis in preventing post-operative wound infections and was associated with a significantly lower risk of Clostridium difficile infection, but it was associated with a higher risk of post-operative renal impairment, especially in orthopedic surgery. CONCLUSIONS: Our findings that Gen/Flu prophylaxis was associated with significantly higher risk of post-operative renal impairment dictate that benefits and risks of Gen/Flu prophylaxis should be carefully assessed and balanced, and each patient should be evaluated individually so that a proper antibiotic prophylaxis regimen could be chosen.
PURPOSE: To conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (Gen/Flu) in preventing post-operative wound infections and their association with risks of Clostridium difficile infections and post-operative renal impairment. METHODS: Published studies including both prophylactic cefuroxime and prophylactic Gen/Flu used in surgery were included for meta analysis. Outcomes were analyzed using a random-effect model or a fixed-effect model depending on the heterogeneity across the included studies. RESULTS:Gen/Flu prophylaxis showed similar efficacy as cefuroxime prophylaxis in preventing post-operative wound infections and was associated with a significantly lower risk of Clostridium difficile infection, but it was associated with a higher risk of post-operative renal impairment, especially in orthopedic surgery. CONCLUSIONS: Our findings that Gen/Flu prophylaxis was associated with significantly higher risk of post-operative renal impairment dictate that benefits and risks of Gen/Flu prophylaxis should be carefully assessed and balanced, and each patient should be evaluated individually so that a proper antibiotic prophylaxis regimen could be chosen.
Entities:
Keywords:
Cefuroxime; flucloxacillin; gentamicin; infection; meta-analysis; prophylaxis; surgery
Authors: Yaremi Quiros; Laura Vicente-Vicente; Ana I Morales; José M López-Novoa; Francisco J López-Hernández Journal: Toxicol Sci Date: 2010-09-09 Impact factor: 4.849