Is the efficacy of antibiotic prophylaxis for surgical procedures decreasing? Systematic review and meta-analysis of randomized control trials

2018 ◽  
Vol 40 (2) ◽  
pp. 133-141 ◽  
Author(s):  
Sumanth Gandra ◽  
Anna Trett ◽  
Gerardo Alvarez-Uria ◽  
Joseph S. Solomkin ◽  
Ramanan Laxminarayan
Keyword(s):  
Systematic Review ◽  
Colorectal Surgery ◽  
Cesarean Section ◽  
Antibiotic Prophylaxis ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Randomized Control Trials ◽  
Postoperative Infections ◽  
Randomized Control ◽  
Tract Infections

AbstractObjectiveRising antibiotic resistance could reduce the effectiveness of antibiotics in preventing postoperative infections. We investigated trends in the efficacy of antibiotic prophylaxis regimens for 3 commonly performed surgical procedures—appendectomy, cesarean section, and colorectal surgery—and 1 invasive diagnostic procedure, transrectal prostate biopsy (TRPB).DesignSystematic review and meta-analysis.MethodsWe searched PubMed and Cochrane databases (through October 31, 2017) for randomized control trials (RCTs) that measured the efficacy of antibiotic prophylaxis for 4 index procedures in preventing postoperative infections (surgical site infections [SSIs] following the 3 surgical procedures and a combination of urinary tract infections [UTIs] and sepsis following TRPB).ResultsOf 399 RCTs, 74 studies (9 appendectomy, 11 cesarean section, 39 colorectal surgery, and 15 TRPB) were included. Multilevel logistic regression models with random intercepts for each study showed no statistically significant increase in SSIs over time for appendectomy (adjusted odds ratio [aOR] per year, 1.03; 95% confidence interval [CI], 0.92–1.16; P=.57), cesarean section (aOR per year, 1.01; 95% CI, 0.96–1.05; P=.80), and TRPB (aOR per year, 0.95; 95% CI, 0.77–1.18; P=.67). However, there was a significant increase in SSIs proportion following colorectal surgery (aOR per year, 1.049; 95% CI, 1.03–1.07; P<.001).ConclusionThe efficacy of antibiotic prophylaxis agents in preventing SSIs following colorectal surgery has declined. Small number of RCTs and low infections rates limited our ability to assess true effect for simple appendectomy, cesarean section, or TRPB.

scholarly journals Changing gloves during cesarean section for prevention of postoperative infections: a systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Siwanon Rattanakanokchai ◽  
Nuntasiri Eamudomkarn ◽  
Nampet Jampathong ◽  
Bao-Yen Luong-Thanh ◽  
Chumnan Kietpeerakool
Keyword(s):  
Systematic Review ◽  
Cesarean Section ◽  
Meta Analysis ◽  
Postoperative Infections ◽  
Quality Of Evidence ◽  
Randomized Controlled ◽  
Incisional Surgical Site Infection ◽  
Grade Approach ◽  
Febrile Morbidity

AbstractThis systematic review and meta-analysis was conducted to assess associations between changing gloves during cesarean section (CS) and postoperative infection. A literature search was conducted using the major electronic databases MEDLINE, Scopus, ISI Web of Science, PubMed, CINAHL, and CENTRAL from their inception to September 2020. Randomized controlled trials (RCTs) comparing glove change during CS to no glove change were included. Outcomes of interest were endometritis, febrile morbidity, and incisional surgical site infection (SSI). GRADE approach was applied to assess the quality of evidence. Ten reports of six studies involving 1707 participants were included in the analyses. Glove change was associated with a reduction in the risk of incisional SSI following CS (pooled RR 0.49, 95% CI 0.30, 0.78; moderate quality of evidence). Compared to no glove change, glove change during CS did not reduce the risks of endometritis (pooled RR 1.00, 95% CI 0.80, 1.24; low quality of evidence) or febrile morbidity (pooled RR 0.85, 95% CI 0.43, 1.71; very low quality of evidence). Changing gloves during CS was associated with a decreased risk of incisional SSI. The risks of postoperative endometritis and febrile morbidity were not altered by changing gloves.

Trauma-Sensitive Yoga Interventions and Posttraumatic Stress and Depression Outcomes Among Women: A Systematic Review and Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Ashleigh Kysar-Moon ◽  
Matthew Vasquez ◽  
Tierra Luppen
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress ◽  
Traumatic Event ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Randomized Control Trials ◽  
Methodological Rigor ◽  
History Of ◽  
Randomized Control ◽  
Analysis Models

Abstract Research shows that most people experience at least one traumatic event in their lifetimes, and between 6% and 8% of those with a history of trauma will develop posttraumatic stress disorder (PTSD) and/or related mental health conditions. Women face a greater threat of trauma exposure and have a higher risk of PTSD and depression than men. Trauma-Sensitive Yoga (TSY), a body-based adjunctive therapy, has shown potential in several studies as an effective method for reducing PTSD and depression symptoms. However, existing research and systematic reviews vary widely in their methodological rigor and comparison samples. Thus, in this systematic review we examined the effectiveness of TSY among women with a history of trauma and depression who had participated in randomized control trials with clear control and experimental groups. Findings in fixed- and mixed-effects meta-analysis models suggest marginally significant to no effects of TSY on PTSD and depression outcomes. Our systematic review highlights critical questions and significant gaps in the existing literature about the rationale and best practices of TSY intervention duration.

Sign in / Sign up

Export Citation Format

Share Document