Table 2.
Summary of intervention measures, antibiotic prophylaxis and outcomes of interests for each study
| Author | Screening method (who receive the inteventions) | inteventional measures (number of days) | Antibiotic prophylaxis | Definition of PJI | Definition of “Any Wound complications” | Intervention group | Control group | ||
|---|---|---|---|---|---|---|---|---|---|
| Events (PJI/superficial) | Total | Events (PJI/superficial) | Total | ||||||
| Stambough et al. 2017 | No screen (all patients) | Mupirocin intranasally 2 daily and chlorhexidine showers 5 days | CAP. High-risk groups and MRSA carriers were given vancomycin in addition to weight-based cefazolin. | MSIS | NHSN guidelines | 5 | 2205 | 15 | 1981 |
| Hofmann et. al. 2017 | No screen (all patients) | Nasal application of mupirocin 2 daily for 5 days | CAP. the intervention group received 1 g of vancomycin as a single preoperative dose. | CDC | NHSN and CDC | 4(1/3) | 538 | 10(7/3) | 496 |
| Hadley et al. 2010 | Nasal swab cultured (all patients) | Mupirocin intranasally and chlorhexidine showers 5 days | CAP. MRSA carriers were given Vancomycin 1 g at least 30 min before incision and every 12 h lasting for 24 h. | NM | CDC. Only deep incisional SSIs were considered clinically relevant and considered in the analysis. | 21 (21/0) | 1644 | 6 (6/0) | 414 |
| Sankar et al. 2005 | Axilla, nose, groin, and any open wounds swab (positive screening results) | Mupirocin or povidone iodine or triclosan was instituted. | cephAzolin or cefuroxime was given one hour before skin incision and continued for 2 more doses 8 and 16 h post-operatively. | NM | NM | 0 | 231 | 1 | 164 |
| Jeans et al. 2018 | Nasal and groin swabs culture (positive screening results) | Bactroban intranasally 4 times/day and bathe with Octenisan for 5 days. | NM | Public Health England’s published standard | Public Health England’s published standard on superficial and deep infection. | 131 | 9318 | 69 | 3593 |
| Rao et al. 2011 | Nasal swab cultures (positive screening results) | Mupirocin intranasally 2 times daily and bathe with chlorhexidine daily for 5 days | CAP. Patients with a history of MRSA infection or for MRSA carriers received vancomycin 1 g 60 min before surgery followed by 1 g every 12 hours for 24 h. | NM | NM | 17 (8/9) | 1285 | 20 (9/11) | 741 |
| Hacek et al. 2008 | Nasal swab real-time PCR (positive screening results) | Mupirocin 2 daily for 5 days | Hip surgery patients received cefazolin prior to surgery while knee surgery patients received vancomycin. | CDC | CDC | 11(2/8) | 912 | 14(0/14) | 583 |
| Pelfort et al. 2019 | Nasal swab culture (positive screening results) | Mupirocin intranasally 3 times daily and chlorhexidine showers 5 days | CAP. MRSA carriers received 1 g of vancomycin. | MSIS | CDC. The superficial infections were confirmed by a positive culture of the drainage of the surgical incision together with the local symptoms and a negative intraarticular culture. | 5 (3/2) | 403 | 17 (10/7) | 400 |
| Sporer et al. 2016 | Nasal swab culture (positive screening results) | Mupirocin intranasally 2 daily along with chlorhexidine showers 5 days | CAP patients who tested positive for MRSA were treated with vancomycin within 2 h preoperatively. | NM | Criteria for SSI included purulent drainage from the wound, serosanguinous drainage from an erythematous incision with a positive wound culture or a note in the medical record. | 33 | 9690 | 16 | 1443 |
CAP conventional antibiotic prophylaxis (patients received a weight-based dose of cefazolin within 1 h before surgical incision and continued for 24 h postoperatively), MSIS Musculoskeletal Infection Society criteria, NHSN National Healthcare Safety Network (a deep SSI was defined as an infection having involvement below fascia, or having one of the following intraoperative findings: deep purulence surrounding the capsule or wound and fascial dehiscence with a positive deep tissue culture or secondary signs of infection), SSIs surgical site infections, CDC Center for Disease Control (The type of infection was recorded as superficial incisional, deep incisional, or organ space/joint)