Summary of findings 2. Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation versus oral antibiotics alone.
| Combined mechanical and oral antibiotic bowel preparation versus oral antibiotics alone | ||||||
| Patient or population: Patients undergoing elective colorectal surgery Setting: Any type of hospital offering elective colorectal resections. Both single and multicentre studies are included Intervention: MBP+oAB Comparison: oAB | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with oAB | Risk with MBP+oAB | |||||
| Surgical site infections follow‐up: 30 days | 68 per 1000 | 59 per 1000 (23 to 151) | RR 0.87 (0.34 to 2.21) | 960 (3 RCTs) | ⊕⊝⊝⊝ Very lowa,b,c | Combined mechanical and oral antibiotic bowel preparation may have no effect on surgical site infections, and the evidence is very uncertain. |
| Anastomotic leakage follow‐up: 30 days | 25 per 1000 | 21 per 1000 (5 to 86) | RR 0.84 (0.21 to 3.45) | 960 (3 RCTs) | ⊕⊕⊝⊝ Lowa,c | Combined mechanical and oral antibiotic bowel preparation may result in no difference in anastomotic leakage. |
| Mortality follow‐up: 30 days | 14 per 1000 | 14 per 1000 (4 to 49) | RR 1.02 (0.30 to 3.50) | 709 (2 RCTs) | ⊕⊕⊝⊝ Lowa,c | Combined mechanical and oral antibiotic bowel preparation may result in no difference in mortality. |
| Incidence of postoperative ileus follow‐up: 30 days | 47 per 1000 | 59 per 1000 (32 to 111) | RR 1.25 (0.68 to 2.33) | 709 (2 RCTs) | ⊕⊕⊝⊝ Lowa,c | Combined mechanical and oral antibiotic bowel preparation may result in no difference in the incidence of postoperative ileus. |
| Length of hospital stay follow‐up: 30 days | In two studies, the reported mean difference between groups was 0.1 and 0.2 (95% CI ‐0.68 to 1.08) days, respectively. | (2 RCTs) | ⊕⊕⊕⊝ Moderatea | Combined mechanical and oral antibiotic bowel preparation probably results in little to no difference in length of hospital stay. | ||
| *The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: confidence interval; RR: risk ratio | ||||||
| GRADE Working Group grades of evidence High certainty: we are very confident that the true effect lies close to that of the estimate of the effect. Moderate certainty: we are moderately confident in the effect estimate: the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low certainty: our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect. Very low certainty: we have very little confidence in the effect estimate: the true effect is likely to be substantially different from the estimate of effect. | ||||||
| See interactive version of this table: https://gdt.gradepro.org/presentations/#/isof/isof_question_revman_web_431253847765418810. | ||||||
a The rating was downgraded by one level because of some concerns about risk of bias, as information on a predefined analysis plan could not be identified for any of the included studies. b The rating was downgraded by one level due to moderate heterogeneity between studies; I2 =69%. c The rating was downgraded by one level due to imprecision, as the confidence interval includes considerable benefit and harm.