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Antibiotic Prophylaxis for Thyroid and Parathyroid Surgery: A Systematic Review and Meta-analysis
Fabio Medas1, Gian Luigi Canu1, Federico Cappellacci1
1Department of Surgical Sciences, University of Cagliari, Cagliari, Italy.
Antibiotic prophylaxis (AP) does not reduce surgical site infections (SSIs) in thyroid and parathyroid surgery. Avoiding AP is recommended to prevent antibiotic resistance and reduce social costs.
Area of Science:
- Endocrine Surgery
- Infectious Disease Control
- Surgical Outcomes
Background:
- Thyroid and parathyroid surgery are clean procedures with a low incidence of surgical site infections (SSIs).
- Despite this, many endocrine surgeons routinely use antibiotic prophylaxis (AP).
Purpose of the Study:
- To evaluate the effectiveness of antibiotic prophylaxis (AP) in reducing SSIs in thyroid and parathyroid surgery.
Main Methods:
- A systematic literature search was conducted across PubMed, Scopus, and ISI-Web of Science.
- A meta-analysis included 6 studies with 4428 patients to assess the efficacy of AP in preventing SSIs.
Main Results:
- The incidence of SSI was 0.6% with AP versus 0.4% without AP (OR, 1.07; P = .915).
- No significant heterogeneity was found among the studies (I² = 40.17%).
- Analysis of moderators like age, drain use, and surgery duration yielded no significant results.
Conclusions:
- Antibiotic prophylaxis (AP) is not effective in reducing SSIs for thyroid and parathyroid surgery.
- Its use should be avoided due to potential negative impacts, including increased social costs and the risk of antibiotic resistance.
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