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. 2015 Oct 15;8(10):17856-67.
eCollection 2015.

Prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies

Shaoning Luo  1 , Yu Lai  2 , Chunxin Liu  1 , Yi Chen  3 , Xiaoyu Qiao  1
Affiliations

Prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies

Shaoning Luo et al. Int J Clin Exp Med. .

Abstract

Purpose: To conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (Gen/Flu) in preventing post-operative wound infections and their association with risks of Clostridium difficile infections and post-operative renal impairment.

Methods: Published studies including both prophylactic cefuroxime and prophylactic Gen/Flu used in surgery were included for meta analysis. Outcomes were analyzed using a random-effect model or a fixed-effect model depending on the heterogeneity across the included studies.

Results: Gen/Flu prophylaxis showed similar efficacy as cefuroxime prophylaxis in preventing post-operative wound infections and was associated with a significantly lower risk of Clostridium difficile infection, but it was associated with a higher risk of post-operative renal impairment, especially in orthopedic surgery.

Conclusions: Our findings that Gen/Flu prophylaxis was associated with significantly higher risk of post-operative renal impairment dictate that benefits and risks of Gen/Flu prophylaxis should be carefully assessed and balanced, and each patient should be evaluated individually so that a proper antibiotic prophylaxis regimen could be chosen.

Keywords: Cefuroxime; flucloxacillin; gentamicin; infection; meta-analysis; prophylaxis; surgery.

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Figures

Figure 1
Figure 1
Flow diagram of the publication selection process.
Figure 2
Figure 2
A. Forest plot of comparison of efficacies of gentamicin/flucloxacillin (Gen/Flu) prophylaxis and cefuroxime prophylaxis in preventing post-operative wound infections: overall effect for dichotomous outcome (fixed-effect model). The diamond stood for pooled effect. No significant difference between the efficacies of Gen/Flu prophylaxis and cefuroxime prophylaxis in preventing post-operative wound infections. B. Funnel plot of studies included in the meta-analysis of efficacies of Gen/Flu prophylaxis and cefuroxime prophylaxis in preventing post-operative wound infections. The symmetrical funnel suggested little or no publication bias in the analysis.
Figure 3
Figure 3
A. Forest plot of comparison of associations of Gen/Flu prophylaxis and cefuroxime prophylaxis with post-operative Clostridium difficile infection: overall effect for dichotomous outcome (fixed-effect model). The diamond stood for pooled effect. Gen/Flu prophylaxis was associated with significantly lower risk of post-operative Clostridium difficile infection. B. Funnel plot of studies included in the meta-analysis of associations of Gen/Flu prophylaxis and cefuroxime prophylaxis with post-operative Clostridium difficile infection. The symmetrical funnel suggested little or no publication bias in the analysis.
Figure 4
Figure 4
A. Forest plot of comparison of associations of Gen/Flu prophylaxis and cefuroxime prophylaxis with post-operative renal impairment: overall effect for dichotomous outcome (random-effect model). The diamond stood for pooled effect. Gen/Flu prophylaxis was associated with significantly higher risk of renal impairment. B. Funnel plot of studies included in the meta-analysis of associations of Gen/Flu prophylaxis and cefuroxime prophylaxis with renal impairment. The symmetrical funnel suggested little or no publication bias in the analysis.
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References

    1. AlBuhairan B, Hind D, Hutchinson A. Antibiotic prophylaxis for wound infections in total joint arthroplasty. J Bone Joint Surg Br. 2008;90:915–919. - PubMed
    1. White RW, West R, Howard P, Sandoe J. Antimicrobial regime for cardiac surgery: the safety and effectiveness of short-course flucloxacillin (or teicoplanin) and gentamicin-based prophylaxis. J Card Surg. 2013;28:512–516. - PubMed
    1. Craxford S, Bayley E, Needoff M. Antibiotic-associated complications following lower limb arthroplasty: a comparison of two prophylactic regimes. Eur J Orthop Surg Traumatol. 2014;24:539–43. - PubMed
    1. Bartlett JG. Historical perspectives on studies of Clostridium difficile and C. difficile infection. Clin Infect Dis. 2008;46(Suppl 1):S4–S11. - PubMed
    1. Challagundla SR, Knox D, Hawkins A, Hamilton D, W V Flynn R, Robertson S, Isles C. Renal impairment after high-dose flucloxacillin and single-dose gentamicin prophylaxis in patients undergoing elective hip and knee replacement. Nephrol Dial Transplant. 2013;28:612–619. - PubMed

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