Evidence map›Paper›PMID 28121028›Full record

SynthesisThe British journal of surgery2017

Network meta-analysis of antibiotic prophylaxis for prevention of surgical-site infection after groin hernia surgery.

T Boonchan, C Wilasrusmee, M McEvoy, J Attia, A Thakkinstian

Open access · bronzeAbstract readSystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The British journal of surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed, 3 pooled it
4.7field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 citations in OpenAlex.

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  20. Surgical site infection: the "Achilles Heel" of all types of abdominal wall hernia reconstruction.Hernia : the journal of hernias and abdominal wall surgery · 2018
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 2 countries.

T BoonchanSection for Clinical Epidemiology and Biostatistics and, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.ORCID http://orcid.org/0000-0002-0926-0138
C WilasrusmeeDepartment of Surgery, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
M McEvoySchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
J AttiaSchool of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia.
A ThakkinstianSection for Clinical Epidemiology and Biostatistics and, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Mahidol University · THUniversity of Newcastle Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFirst-generation cephalosporins (such as cefazolin) are recommended as antibiotic prophylaxis in groin hernia repair, but other broad-spectrum antibiotics have also been prescribed in clinical practice. This was a systematic review and network meta-analysis to compare the efficacy of different antibiotic classes for prevention of surgical-site infection (SSI) after hernia repair.

methodsRCTs were identified that compared efficacy of antibiotic prophylaxis on SSI after inguinal or femoral hernia repair from PubMed and Scopus databases up to March 2016. Data were extracted independently by two reviewers. Network meta-analysis was applied to assess treatment efficacy. The probability of being the best antibiotic prophylaxis was estimated using surface under the cumulative ranking curve (SUCRA) analysis.

resultsFifteen RCTs (5159 patients) met the inclusion criteria. Interventions were first-generation (7 RCTs, 1237 patients) and second-generation (2 RCTs, 532) cephalosporins, β-lactam/β-lactamase inhibitors (6 RCTs, 619) and fluoroquinolones (2 RCTs, 581), with placebo as the most common comparator (14 RCTs, 2190). A network meta-analysis showed that β-lactam/β-lactamase inhibitors and first-generation cephalosporins were significantly superior to placebo, with a pooled risk ratio of 0·44 (95 per cent c.i. 0·25 to 0·75) and 0·62 (0·42 to 0·92) respectively. However, none of the antibiotic classes was significantly different from the others. SUCRA results indicated that β-lactam/β-lactamase inhibitors and first-generation cephalosporins were ranked first and second respectively for best prophylaxis.

conclusionβ-Lactam/β-lactamase inhibitors followed by first-generation cephalosporins ranked as the most effective SSI prophylaxis for adult patients undergoing groin hernia repair.

Indexed as

Antibiotic ProphylaxisAnti-Bacterial Agentsbeta-Lactamase InhibitorsCephalosporinsHernia, FemoralHernia, InguinalHumansRandomized Controlled Trials as TopicSurgical Wound InfectionAnti-Bacterial Agentsbeta-Lactamase InhibitorsCephalosporins

Identifiers

PMID28121028
PMCPMC5299528
OpenAlexW2579902087

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.