Table 4.
Length of hospital stay and mortality associated with preoperative prophylactic antibiotics
| Population | Length of hospital stay* | Mortality‡ | ||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Reference | Surgical procedure | Preoperative prophylaxis | C | I | C | I | No infection | Infection | P | C | I | P |
| Blair et al.35 § | Neck dissection | No prophylaxis versus cefazolin, clindamycin and cefoperazone | 99 | 93 | 8 (4–22) | 23 (10–73) | n.c. | n.s. | n.s. | |||
| Bold et al.36 ¶ | Axillary lymph node dissection | Placebo (normal saline) versus cefonicid | 90 | 88 | 5·9 (2–15) | 3 | n.c. | n.s. | n.s. | |||
| Davey et al.37 | AH or VH | AH: placebo (normal saline) versus cephradine | 102 | 97 | 8·7 (8·2–9·2) | 8·0 (7·7–8·3) | n.c | n.s. | n.s. | |||
| AH: placebo (normal saline) versus mezlocillin | 101 | 8·7 (8·2–9·2) | 7·9 (7·6–8·2) | n.c. | n.s. | n.s. | ||||||
| VH: placebo (normal saline) versus cephradine | 29 | 34 | 7·2 (6·7–7·7) | 8·1 (7·2–9·0) | n.c. | n.s. | n.s. | |||||
| VH: placebo (normal saline) versus mezlocillin | 37 | 7·2 (6·7–7·7) | 7·3 (7·0–7·6) | n.c. | n.s. | n.s. | ||||||
| Dhadwal et al.38 # | CABG | Cefuroxime versus rifampicin + gentamicin + vancomycin | 106 | 95 | 11·7 (4–69) | 9·5 (4–73) | 0·063 | 4 (4) | 1 (1) | 0·630 | ||
| Dijksman et al.39 | Digestive tract surgery | Placebo, cefuroxime and metronidazole versus SDD, cefuroxime and metronidazole | 146 | 143 | (12, 9–18) | (11, 9–14) | 0·055 | 5 (3·4) | 6 (4·2) | 0·732 | ||
| Garcia‐Rodriguez et al.40 ** | Gastroduodenal or biliary surgery | Cefoxitin versus cefotaxime | 716 | 722 | 11·7 (4–69) | 9·5 (4–73) | 10·2 (9·9–10·5) | 13·7 (12·4–15·0) | < 0·001 | 7 (0·6) | 4 (0·6) | n.s. |
| Jones et al.41 †† | Hysterectomy, genitourinary, gastrointestinal and other (mainly orthopaedic total joint replacement and open reduction of fractures) surgery | Cefotaxime versus cefoperazone | 401 | 411 | 11·5 (12–30) | 14·3 (12–30) | n.c. | n.s. | n.s. | |||
| Marroni et al.42 | Abdominal aortic or lower limb prosthetic vascular surgery | Cefazolin versus teicoplanin | 119 | 119 | 14·8 | 16·2 | n.c. | 3 (2·5) | 4 (3·4) | 1·000 | ||
| Matkaris et al.43 | AH | No antibiotic prophylaxis versus ceftriaxone | 50 | 50 | 5·46 | 4·32 | < 0·001 | n.s. | n.s. | |||
| No antibiotic prophylaxis versus cefotaxime | 50 | 5·46 | 4·36 | < 0·001 | n.s. | n.s. | ||||||
| No antibiotic prophylaxis versus ceftazidime | 50 | 5·46 | 4·50 | < 0·001 | n.s. | n.s. | ||||||
| Matsui et al.44 ‡‡ | Laparoscopic cholecystectomy for removal of gallbladder stones or polyps | No antibiotic prophylaxis versus cefazolin | 519 | 518 | 4·07(3·00)† | 3·69(5·26)† | 0·010 | 0 (0) | 0 (0) | |||
| Sisto et al.45 | CABG | Ceftriaxone versus cefuroxime | 274 | 277 | n.s. | n.s. | n.c. | 3 (1·1) | 4 (1·4) | 1·000 | ||
| Wilson et al.46 §§ | Colorectal surgery | Ertapenem versus cefotetan | 338 | 334 | 7·6 (6·8–8·2) | 8·7 (7·7–9·7) | n.c. | 3 of 451 (0·7) | 7 of 450 (1·6) | 0·340 | ||
Values are mean (median, range) unless indicated otherwise;
values are mean(s.d.).
Values in parentheses are percentages.
Infection rate and length of stay (LOS) for cefazolin, clindamycin and cefoperazone were pooled as individual results were not stated; mean cost per patient was based on length of hospital stay (LOS).
Patients with infection were admitted to hospital (7 placebo, 1 intervention).
Mann–Whitney U test for LOS and χ2 test with Yates' correction for mortality.
Intention‐to‐treat data; infection data were missing for six patients in the control group and seven in the intervention group.
Per‐protocol data.
Intention‐to‐treat data.
Per‐protocol data; intention‐to‐treat data used for mortality reported in the nested study of Itani et al.48. C, control; I, intervention; n.c., not calculated (insufficient data in article); n.s., not stated; AH, abdominal hysterectomy; VH, vaginal hysterectomy; CABG, coronary artery bypass graft; SDD, selective decontamination of the digestive tract. P values are those reported in the article.