Electronic Resource
Single- versus multiple-dose antimicrobial prophylaxis for major surgery: A systematic review.
| العنوان: | Single- versus multiple-dose antimicrobial prophylaxis for major surgery: A systematic review. |
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| المؤلفون: | Mcdonald M., Forbes A., Marshall C., Grabsch E. |
| بيانات النشر: | Blackwell Publishing Australia 1998-07-20 |
| نوع الوثيقة: | Electronic Resource |
| مستخلص: | Background: Single-dose antimicrobial prophylaxis for major surgery is a widely accepted principle; recommendations have been based on laboratory studies and numerous clinical trials published in the last 25 years. In practice, single-dose prophylaxis has not been universally accepted and multiple-dose regimens are still used in some centres. Moreover, the principle has recently been challenged by the results of an Australian study of vascular surgery. The aim of this current systematic review is to determine the overall efficacy of single versus multiple-dose antimicrobial prophylaxis for major surgery and across surgical disciplines. Method(s): Relevant studies were identified in the medical literature using the MEDLINE database and other search strategies. Trials included in the review were prospective and randomized, had the same antimicrobial in each treatment arm and were published in English. Rates of postoperative surgical site infections (SSI) were extracted, 2 x 2 tables prepared and odds ratios (OR) [With 95% confidence intervals (95% CI)] calculated. Data were then combined using fixed and random effects models to provide an overall figure. In this context, a high value for the combined OR, with 95% CI > 1.0, indicates superiority of multiple-dose regimens and a low OR, with 95% CI < 1.0, suggests the opposite. A combined OR close to 1.0, with narrow 95% CI straddling 1.0, indicates no clear advantage of one regimen over another. Further subgroup analyses were also performed. Result(s): Combined OR by both fixed (1.06, 95% CI, 0.89-1.25) and random effects (1.04, 95% CI, 0.86-1.25) models indicated no clear advantage of either single or multiple-dose regimens in preventing SSI. Likewise, subgroup analysis showed no statistically significant differences associated with type of antimicrobial used (beta-lactam vs other), blinded wound assessment, length of the multiple-dose arm (> 24 h vs 24 h or less) or type of surgery (obstetric and gynecological vs othe |
| مصطلحات الفهرس: | antiinfective agent/dt [Drug Therapy], antiinfective agent/pe [Pharmacoeconomics], beta lactam antibiotic/ct [Clinical Trial], beta lactam antibiotic/do [Drug Dose], beta lactam antibiotic/dt [Drug Therapy], beta lactam antibiotic/pe [Pharmacoeconomics], cefalotin/ct [Clinical Trial], cefalotin/do [Drug Dose], cefalotin/dt [Drug Therapy], cefalotin/pe [Pharmacoeconomics], cefazolin/ct [Clinical Trial], cefazolin/do [Drug Dose], cefazolin/dt [Drug Therapy], cefazolin/pe [Pharmacoeconomics], cefotaxime/ct [Clinical Trial], cefotaxime/do [Drug Dose], cefotaxime/dt [Drug Therapy], cefotaxime/pe [Pharmacoeconomics], cefoxitin/ct [Clinical Trial], cefoxitin/do [Drug Dose], cefoxitin/dt [Drug Therapy], cefoxitin/pe [Pharmacoeconomics], cefradine/ct [Clinical Trial], cefradine/do [Drug Dose], cefradine/dt [Drug Therapy], cefradine/pe [Pharmacoeconomics], ceftazidime/ct [Clinical Trial], ceftazidime/do [Drug Dose], ceftazidime/dt [Drug Therapy], ceftazidime/pe [Pharmacoeconomics], cefuroxime/ct [Clinical Trial], cefuroxime/do [Drug Dose], cefuroxime/dt [Drug Therapy], cefuroxime/pe [Pharmacoeconomics], cotrimoxazole/ct [Clinical Trial], cotrimoxazole/do [Drug Dose], cotrimoxazole/dt [Drug Therapy], cotrimoxazole/pe [Pharmacoeconomics], doxycycline/ct [Clinical Trial], doxycycline/do [Drug Dose], doxycycline/dt [Drug Therapy], doxycycline/pe [Pharmacoeconomics], fleroxacin/ct [Clinical Trial], fleroxacin/do [Drug Dose], fleroxacin/dt [Drug Therapy], fleroxacin/pe [Pharmacoeconomics], gentamicin/ct [Clinical Trial], gentamicin/do [Drug Dose], gentamicin/dt [Drug Therapy], gentamicin/pe [Pharmacoeconomics], latamoxef/ct [Clinical Trial], latamoxef/do [Drug Dose], latamoxef/dt [Drug Therapy], latamoxef/pe [Pharmacoeconomics], metronidazole/ct [Clinical Trial], metronidazole/do [Drug Dose], metronidazole/dt [Drug Therapy], metronidazole/pe [Pharmacoeconomics], mezlocillin/ct [Clinical Trial], mezlocillin/do [Drug Dose], mezlocillin/dt [Drug Therapy], mezlocillin/pe [Pharmacoeconomics], piperacillin/ct [Clinical Trial], piperacillin/do [Drug Dose], piperacillin/pe [Pharmacoeconomics], tinidazole/ct [Clinical Trial], tinidazole/do [Drug Dose], tinidazole/dt [Drug Therapy], tinidazole/pe [Pharmacoeconomics], piperacillin/dt [Drug Therapy], antibiotic prophylaxis, clinical trial, dose response, drug efficacy, human, major surgery, postoperative infection/dm [Disease Management], postoperative infection/dt [Drug Therapy], postoperative infection/pc [Prevention], practice guideline, review, surgical infection/dm [Disease Management], surgical infection/dt [Drug Therapy], surgical infection/pc [Prevention], antiinfective agent/ct [Clinical Trial], antiinfective agent/do [Drug Dose], Review |
| URL: | Australian and New Zealand Journal of Surgery Click here for full text options LibKey Link |
| الاتاحة: | Open access content. Open access content Copyright 2020 Elsevier B.V., All rights reserved. |
| Other Numbers: | AUSHL oai:repository.monashhealth.org:1/33460 Australian and New Zealand Journal of Surgery. 68 (6) (pp 388-395), 1998. Date of Publication: 1998. 0004-8682 https://repository.monashhealth.org/monashhealthjspui/handle/1/33460 9623456 [http://www.ncbi.nlm.nih.gov/pubmed/?term=9623456] 28253184 (Mcdonald) Infectious Diseases Service, Geelong Hospital, Geelong, Vic., Australia (Grabsch) Dept. Infect. Dis. Clin. Epidemiol., Monash Medical Centre, Clayton, Vic., Australia (Marshall) Dept. of Microbiol. and Infect. Dis., Royal Children's Hospital, Parkville, Vic., Australia (Forbes) Dept. Epidemiol. Preventative Med., Monash University, Alfred Hospital Campus, Prahran, Vic., Australia (Mcdonald) 68 Myers Street, Geelong, Vic. 3220, Australia Mcdonald M.; sam-mal@gsat.edu.au 1305127803 |
| المصدر المساهم: | MONASH HEALTH LIBRS From OAIster®, provided by the OCLC Cooperative. |
| رقم الانضمام: | edsoai.on1305127803 |
| قاعدة البيانات: | OAIster |
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