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Safety and efficacy of antibiotic prophylaxis in patients undergoing elective laparoscopic cholecystectomy: A systematic review and meta‐analysis
Author(s) -
Liang Bo,
Dai Min,
Zou Zhenhong
Publication year - 2016
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13246
Subject(s) - medicine , antibiotic prophylaxis , relative risk , cochrane library , placebo , meta analysis , randomized controlled trial , antibiotics , adverse effect , cholecystectomy , incidence (geometry) , subgroup analysis , confidence interval , surgery , physics , alternative medicine , optics , pathology , microbiology and biotechnology , biology
Background and Aim: Owing to persistent controversy regarding the use of routine antibiotic prophylaxis in patients undergoing elective laparoscopic cholecystectomy and the availability of several new randomized controlled trials (RCTs), we conducted an up‐to‐date meta‐analysis to provide the best current evidence. The aim of the article is to evaluate the safety and efficacy of routine antibiotic prophylaxis in low‐risk patients undergoing elective laparoscopic cholecystectomy. Methods: We conducted a comprehensive literature review of the PubMed, Embase, and Cochrane Library databases for RCTs that compared antibiotic prophylaxis versus placebo or no antibiotics in low‐risk patients undergoing elective laparoscopic cholecystectomy. Results: The meta‐analysis included 21 RCTs (5207 patients). Antibiotic prophylaxis reduced the incidence of surgical site infections (risk ratio [RR] 0.61, 95% confidence interval [CI] 0.45 to 0.82, P = 0.001) and global infections (RR 0.55, 95% CI 0.38 to 0.79, P = 0.001) during hospitalization or after discharge, and postoperative length of hospital stay (weighted mean difference −0.16, 95% CI −0.28 to −0.04, P = 0.008). No adverse events were reported. Subgroup analyses demonstrated that two doses of antibiotic and 3–10 doses of antibiotic significantly reduced the incidence of surgical site infections compared with placebo or no antibiotics (two doses: RR 0.16, 95% CI 0.06–0.47; 3–10 doses: RR 0.46, 95% CI 0.27–0.80), while a single dose of antibiotic administration did not. Conclusion: Antibiotic prophylaxis is safe and effective in reducing surgical site infections and global infections during hospitalization or after discharge, and postoperative length of hospital stay in low‐risk patients undergoing elective laparoscopic cholecystectomy.