Evidence map›Paper›PMID 35842898›Full record

SynthesisBreast cancer (Tokyo, Japan)2022

Antibiotic prophylaxis in breast surgery: a meta-analysis to identify the optimal strategy to reduce infection rates in breast surgery.

Benyamin Alam, Amir Reza Akbari, Bader Alali, Edwin Thankan, Shaida Ekhlacy

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in Breast cancer (Tokyo, Japan), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
1.3field-weighted citation impact, top 20% 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, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Review
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 5 institutions in 2 countries.

Benyamin AlamQueen Elizabeth Hospital, Birmingham, B15 2WB, UK. benyamin.alam3@nhs.net.ORCID http://orcid.org/0000-0002-6349-2650
Amir Reza AkbariKing's Mill Hospital, Sutton-In-Ashfield, NG17 4JL, UK.
Bader AlaliMubarak Al Kabeer Hospital, Block 4 Street 109, Jabriya, Kuwait.
Edwin ThankanPilgrim Hospital, Sibsey Road, Boston, Lincolnshire, PE21 9QS, UK.
Shaida EkhlacyUniversity of Birmingham, Birmingham, B15 2SQ, UK.
Kings Mill Hospital · GBMubarak Al Kabeer Hospital · KWPilgrim Hospital · GBQueen Elizabeth Hospital Birmingham · GBUniversity of Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introBreast surgeries are an increasingly frequent operation, with an exponential rise in breast cancer diagnoses, and women opting for cosmetic surgeries. SSIs are the most common post-operative complication with many negative consequences including sepsis and even death. These are treated with prophylactic antibiotics prior to surgery. Breast surgery is currently defined as 'clean', although literature indicates that the infection rate is higher than should be expected for this classification. The aim of this meta-analysis is to evaluate whether pre-operative antibiotics reduce SSI frequency and which class of antibiotics achieve the best reduction.

methodsA literature search through online libraries was used to find clinical trials investigating pre-breast-surgery antibiotics and SSI frequency. These were grouped all together and separately by class of antibiotics. Additionally studies investigating breast cancer surgeries and non-cancer surgeries were grouped separately. A forest-plot was created for each group to calculate an estimated effect, these were then compared against each other.

resultsUse of antibiotics resulted in a reduction in SSI frequency by 3.55% overall, and reduced frequency in all types of surgeries performed. Cephalosporins reduced SSI frequency by 2.23%, Beta-lactamase inhibitors 4.17% and macrolides achieved the greatest effect with a 14.58% reduction.

conclusionThis meta-analysis proves that antibiotics reduce SSI frequency in breast surgery and supports the notion to remove the 'clean' classification. This definition may result in failure to provide prophylaxis, resulting in patients suffering from preventable SSIs and their negative consequences. Macrolides were the most effective followed by beta-lactamase inhibitors and cephalosporins, this may be implemented in structuring new guidelines favouring use of macrolides before conducting breast surgery.

Indexed as

Antibiotic ProphylaxisBreast NeoplasmsAnti-Bacterial Agentsbeta-Lactamase InhibitorsCephalosporinsFemaleHumansMacrolidesPenicillinsSurgical Wound InfectionAnti-Bacterial Agentsbeta-Lactamase InhibitorsCephalosporinsMacrolidesPenicillinsAntibioticsBreast surgerySurgical Site Infections

Identifiers

PMID35842898
OpenAlexW4285676576

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.