Summary of findings 3. Summary of findings table ‐ Combined mechanical and oral antibiotic bowel preparation versus no bowel preparation.
| Combined mechanical and oral antibiotic bowel preparation versus no bowel preparation | ||||||
| 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: nBP | ||||||
| Outcomes | Anticipated absolute effects* (95% CI) | Relative effect (95% CI) | № of participants (studies) | Certainty of the evidence (GRADE) | Comments | |
| Risk with nBP | Risk with MBP+oAB | |||||
| Surgical site infections follow‐up: 30 days | 105 per 1000 | 66 per 1000 (35 to 129) | RR 0.63 (0.33 to 1.23) | 396 (1 RCT) | ⊕⊕⊝⊝ Lowa | Combined mechanical and oral antibiotic bowel preparation may result in little to no difference in surgical site infections. |
| Anastomotic leakage follow‐up: 30 days | 40 per 1000 | 36 per 1000 (13 to 97) | RR 0.89 (0.33 to 2.42) | 396 (1 RCT) | ⊕⊕⊝⊝ Lowa | Combined mechanical and oral antibiotic bowel preparation may result in no difference in anastomotic leakage. |
| Mortality follow‐up: 30 days | 10 per 1000 | 2 per 1000 (0 to 42) | RR 0.20 (0.01 to 4.22) | 396 (1 RCT) | ⊕⊕⊝⊝ Lowa | Combined mechanical and oral antibiotic bowel preparation may result in little to no difference in mortlaity. |
| Incidence of postoperative ileus follow‐up: 30 days | 160 per 1000 | 189 per 1000 (123 to 290) | RR 1.18 (0.77 to 1.81) | 396 (1 RCT) | ⊕⊕⊝⊝ Lowa | Combined mechanical and oral antibiotic bowel preparation may result in no difference in incidence of postoperative ileus. |
| Length of hospital stay follow‐up: 30 days | MD 0.1 higher (0.8 lower to 1 higher) | ‐ | 396 (1 RCT) | ⊕⊕⊝⊝ Lowa | Combined mechanical and oral antibiotic bowel preparation may result in 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; MD: mean difference; 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_431253860479140670. | ||||||
a The rating was downgraded by two levels due to imprecision because of the small sample size and the wide confidence intervals, which include considerable benefit and harm.