Utility of preoperative prophylactic antibiotics for preventing surgical site infections in children with infantile hypertrophic pyloric stenosis: a systematic review and meta-analysis.

IF 1.5 3区 医学 Q2 PEDIATRICS Pediatric Surgery International Pub Date : 2024-11-06 DOI:10.1007/s00383-024-05883-x
Annu Gulia, Hemant Khandelia, Vikas Dhikav, Sachit Anand
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Abstract

Purpose: The aim of this study was to determine the utility of prophylactic antibiotics before pyloromyotomy for the prevention of Surgical Site Infections (SSI) among children with Infantile Hypertrophic Pyloric Stenosis (IHPS).

Methods: A systematic search of PubMed, Scopus, Embase, and Web of Science databases was performed to identify papers published till 30th July 2024. The main outcome of interest was the incidence of SSIs. The relative risk (RR) with 95% confidence interval (CI) was calculated using a random effects model. The I2 statistic was used to calculate the heterogeneity. The Newcastle-Ottawa-Scale (NOS) was used to assess the methodological quality of the included studies.

Results: Five studies, published between 1999 and 2024, were included in this systematic review and meta-analysis. The risk of developing SSI among those treated was RR = 0.97, 95% CI 0.53 to 1.78, with I2 = 0%, indicating no incremental benefit of administration of prophylactic antibiotics. A sensitivity analysis was performed by excluding the database studies. Results from this analysis (RR = 0.79, 95% CI 0.29 to 2.20, I2 = 0%) demonstrated that no significant difference was observed after excluding studies with large sample sizes. All included studies were of good methodological quality as assessed with the NOS.

Conclusion: The findings of this review demonstrate no incremental benefit of the administration of prophylactic antibiotics before pyloromyotomy in preventing SSIs in children with IHPS. However, randomized, double-blinded, placebo-controlled trials need to be conducted in the future before any definite conclusions are drawn in this regard.

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婴幼儿肥厚性幽门狭窄患儿术前使用预防性抗生素预防手术部位感染的效用:系统回顾和荟萃分析。
目的:本研究旨在确定幽门切开术前预防性使用抗生素对预防婴儿肥厚性幽门狭窄症(IHPS)患儿手术部位感染(SSI)的作用:对PubMed、Scopus、Embase和Web of Science数据库进行了系统检索,以确定截至2024年7月30日发表的论文。主要研究结果是 SSI 的发生率。采用随机效应模型计算相对风险 (RR) 和 95% 置信区间 (CI)。I2统计量用于计算异质性。纽卡斯尔-渥太华量表(NOS)用于评估纳入研究的方法学质量:本系统综述和荟萃分析共纳入了 5 项研究,这些研究发表于 1999 年至 2024 年之间。接受治疗者发生 SSI 的风险为 RR = 0.97,95% CI 0.53 至 1.78,I2 = 0%,表明使用预防性抗生素无增量效益。通过排除数据库研究,进行了一项敏感性分析。该分析的结果(RR = 0.79,95% CI 0.29 至 2.20,I2 = 0%)表明,排除样本量大的研究后未观察到显著差异。根据 NOS 评估,所有纳入的研究都具有良好的方法学质量:本综述的研究结果表明,在幽门切开术前使用预防性抗生素对预防IHPS患儿的SSI并无增量益处。不过,在就此得出明确结论之前,今后还需要进行随机、双盲、安慰剂对照试验。
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来源期刊
CiteScore
3.00
自引率
5.60%
发文量
215
审稿时长
3-6 weeks
期刊介绍: Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor
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