Table 8. Antibiotic prophylaxis for the prevention of deep surgical-site infections in abdominal trauma with enteric contamination - Level of evidence and recommendations.
Query | Desirable effect | Undesirable effect* | Benefit/risk profile | Values and preferences | Resource use | Recommendation | Rationale |
Penetrating abdominal trauma - 24-hour cefoxitin or cefotetan vs. 5-day cefoxitin or cefotetan | Very low evidence in favour of intervention □□□ | No evidence against intervention □□□□ | Favourable | Not available | Wise | Weak in favour of intervention | Only part of the patients had intestinal perforation, but no specific data is available for this subset; this hampers conclusive answers regarding patients with perforation, the focus of the review. However, the risk of resistant bacteria selection is itself a sufficient |
Penetrating abdominal trauma - 24-hour ampicillin-sulbactam vs. 5-day ampicillin-sulbactam | Very low evidence in favour of intervention □□□ | No evidence against intervention □□□□ | Favourable | Not available | Wise | Weak in favour of intervention | condition to contraindicate the 5-day antibiotic course. We assume that single-day prophylaxis is effective on the basis of indirect evidence from elective abdominal-surgery antibiotic prophylaxis studies and less dangerous in terms of antibiotic-resistant bacteria selection than a 5-day treatment. This issue however deserves further investigations. |
Penetrating abdominal trauma - 24-hour cefoxitin vs. 5-day cefoxitin | Very low evidence in favour of intervention □□□ | No evidence against intervention □□□□ | Favourable | Not available | Wise | Weak in favour of intervention |
*Not investigated in the studies, no evidence could be found from external sources.