Evidence map›Paper›PMID 32564129›Full record

SynthesisArchives of gynecology and obstetrics2020

The use of metronidazole in women undergoing obstetric anal sphincter injuries: a systematic review of the literature.

Reut Rotem, Salvatore Andrea Mastrolia, Misgav Rottenstreich, David Yohay, Adi Y Weintraub

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Archives of gynecology and obstetrics, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 29% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. A review of open pelvic fractures with concurrent genitourinary injuries.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2023
    Review
  2. Use of antibiotics in women undergoing correction of an obstetric anal sphincter injury: Results from a national Israeli survey.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2023
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Reut RotemDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, 12 Bayit Street, 91031, Jerusalem, Israel.
Salvatore Andrea MastroliaDepartment of Obstetrics and Gynecology, Ospedaledei Bambini "Vittore Buzzi", University of Milan, Milan, Italy.
Misgav RottenstreichDepartment of Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew University Medical School, 12 Bayit Street, 91031, Jerusalem, Israel. misgavr@gmail.com.ORCID http://orcid.org/0000-0003-4875-1455
David YohayDepartment of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Adi Y WeintraubDepartment of Obstetrics and Gynecology, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Ben-Gurion University of the Negev · ILShaare Zedek Medical Center · ILUniversity of Milan · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeAntibiotic treatment during surgical repair of obstetric anal sphincter injuries (OASIS) had been a matter of debate. We aimed to review the available literature regarding the efficacy of metronidazole administration in women undergoing perineal repair following obstetric OASIS. STUDY

designTo identify potentially eligible studies, we searched PubMed, Scopus, Embase and the Cochrane Library from inception to January 13th, 2019.Reference lists of identified studies were searched. No language restrictions were applied. We used a combination of keywords and text words represented by "Metronidazole", "obstetrics", "obstetric anal sphincter injury", "OASIS", "third degree tear", "fourth degree tear", "third degree laceration", "fourth degree laceration", "antibiotic therapy", "perineal damage" and "perineal trauma". Two reviewers independently screened the titles and abstracts of records retrieved from the database searches. Both reviewers recommended studies for the full-text review. Thescreen of full-text articles recommended by at least one reviewer was done independently by the same two reviewers and assessedfor inclusion in the systematic review. Disagreements between reviewers were resolved by consensus.

resultsThe electronic database search yielded a total of 54,356 results (Fig. 1). After duplicate exclusion 28,154 references remained. Of them, 26 were relevant to the review based on title and abstract screening. None of these articles dealt with the use of metronidazole for the prevention of infections complicating anal sphincter repair in women with OASIS. A Cochrane review addressing antibiotic prophylaxis for patients following OASIS, compared prophylactic antibiotics against placebo or no antibiotics, included only one randomized controlled trial of 147 participants. This study showed that prophylactic antibiotics (not metronidazole) may be helpful to prevent perineal wound complications following OASIS. Fig. 1 Study seection process

conclusionAnaerobic infections potentially complicate wound repair after OASIS. Although scientific societies recommend the use of antibiotics for the prevention of infectious morbidity after OASIS, no study has specifically assessed the role of metronidazole.

Indexed as

AdultAnal CanalAnti-Bacterial AgentsAntibiotic ProphylaxisDelivery, ObstetricFemaleHumansLacerationsMetronidazoleObstetric Labor ComplicationsObstetricsPerineumPregnancyWound InfectionWounds and InjuriesAnti-Bacterial AgentsMetronidazoleAntibioticsInfections preventionMetronidazoleOASISPerineal damage

Identifiers

PMID32564129
OpenAlexW3036105616

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.