Artikel
Third-generation cephalosporins compared to other conservative antibiotic regimens prophylaxis in neurosurgery – A meta-analysis
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Veröffentlicht: | 21. Mai 2013 |
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Gliederung
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Objective: To analysis whether third-generation Cephalosporins as prophylactic antibiotics are superior to other conservative regimen to protect surgical site infection (SSI) in neurosurgical procedures.
Method: Data on SSI as end-point from randomized controlled trials (RCTs), which compared between third-generation cephalosporins and conservative regimens for prophylaxis in neurosurgical procedures, were pooled in a fixed-effects meta-analysis.
Results: Five prospective randomized trials enrolling 2209 patients were identified in all kinds of SSI. The pooled odds ratio for all kinds of SSI with third-generation cephalosporins prophylaxis in the five RCTs was 0.94 (95% CI, 0.59-1.52; P=0.81). It shows no significant difference between two regimens. When analysing organ SSI, four trials enrolling 1596 patients, the pooled odds ratio for organ SSI with third-generation cephalosporins prophylaxis in the four RCTs was 0.88 (95% CI, 0.45-1.74; P=0.72), so there is no advantage when third-generation cephalosporin prophylaxis is used.
Conclusions: Third-generation Cephalosporin prophylaxis has no more benefit than other regimens in neurosurgical procedures; whether for incision or organ SSI. Fearing side effects of widely used third-generation cephalosporins, we should stop using them for prophylaxis in neurosurgery until further study proved their merits.