Antibiotic prophylaxis for surgical procedures: a scoping review

Area of Science:

• Infectious Diseases
• Surgical Outcomes
• Evidence Synthesis

Background:

• Surgical antibiotic prophylaxis (SAP) is crucial for preventing surgical site infections (SSIs).
• Understanding current evidence on SAP administration is essential for optimizing patient outcomes.
• Knowledge gaps in SAP research need identification to guide future studies.

Purpose of the Study:

• To map existing evidence on surgical antibiotic prophylaxis (SAP) administration.
• To identify knowledge gaps in the literature concerning SAP.
• To inform the development of global guidelines for SSI prevention.

Main Methods:

• A comprehensive literature search was conducted in PubMed, Cochrane Library, Epistemonikos, and Health Systems Evidence databases.
• Systematic reviews published between January 2015 and March 2020 were included.
• The quality of included reviews was assessed using AMSTAR 2, with data extracted for primary outcomes.

Main Results:

• Eighty-three systematic reviews were analyzed, focusing on antibiotic timing, drug class, and SSI as the primary outcome.
• Overall, SAP demonstrated a reduction in SSIs compared to placebo or no prophylaxis.
• Intraoperative SAP was associated with lower SSI rates, whereas postoperative SAP did not show a statistically significant benefit.

Conclusions:

• Surgical antibiotic prophylaxis plays a confirmed role in reducing postoperative SSIs across various surgical procedures.
• Current evidence does not support the routine use of antibiotics after surgery to prevent infections.
• Further high-quality systematic reviews and research in diverse populations and settings are needed to enhance the evidence base for SSI prevention guidelines.