Intraoperative redosing of antibiotics for prevention of surgical site infections: A systematic review and meta‐analysis
Year: 2024
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: Appropriate antibiotic prophylaxis is essential for preventing surgical site infections (SSI); however, the clinical benefit of intraoperative redosing remains unclear and controversial owing to insufficient reliable evidence. Therefore, we performed a systematic review and meta-analysis to assess the effectiveness of prophylactic antibiotic redosing in lengthy surgical procedures. Methods: We systematically searched the PubMed, Cochrane Library, Web of Science, and Ichushi-Web databases for articles published until 31 December, 2023. We compared the incidence of SSI between patients receiving and not receiving intraoperative redosing of antibiotics in surgeries lasting ≥3 h. Subgroup analyses were conducted across study characteristics. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using the Mantel-Haenszel random effects model. The risk of bias was assessed using the ROBINS-I. Results: = 0.02). Subgroup analyses showed that intraoperative redosing decreased SSI risk in studies with a minimum 4-h operative time, no postoperative antibiotic continuation, and a moderate risk of bias. However, the statistical heterogeneity of the analyses was high among the studies. Conclusions: Intraoperative redosing with prophylactic antibiotics during lengthy surgeries may be associated with a lower risk of SSI than non-redosing. Therefore, we recommend intraoperative redosing for surgeries lasting beyond 3-4 h to reduce the risk of infection. Further research is required to clarify the optimal redosing interval, which should be prioritized in future studies.
DOI: 10.1002/ags3.12866
Authors: Yuki Hanai, Jun Hirai, Masahiro Kobayashi, Kazuhiro Matsuo, Keita Kouzu, Hiroji Shinkawa, Seiichi Shinji, Motomu Kobayashi, Yuichi Kitagawa, Chizuru Yamashita, Yasuhiko Mohri, Hiroshi Nobuhara, Katsunori Suzuki, Junzo Shimizu, Motoi Uchino, Seiji Haji, Masahiro Yoshida, Toru Mizuguchi, Toshihiko Mayumi, Yuko Kitagawa, Hiroki Ohge
Institutions: Toho University, Aichi Medical University, Aichi Medical University Hospital, Kitasato University, National Defense Medical College Hospital, National Defense Medical College, Osaka Metropolitan University, Nippon Medical School, Keio University, National Center for Geriatrics and Gerontology, Fujita Health University, Mie Prefectural General Medical Center, Hiroshima Prefectural Hospital, University of Occupational and Environmental Health Japan, Toyonaka Municipal Hospital, Hyogo Medical University, Soseikai General Hospital, International University of Health and Welfare, Sapporo Medical University, Japan Community Healthcare Organization, Chukyo Hospital, Hiroshima University Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,035
OpenAlex ID: W4403548423