Prophylactic antibiotics to prevent surgical site infection after breast cancer surgery.

Abstract:

BACKGROUND:Surgery has been used as part of breast cancer treatment for centuries; however any surgical procedure has the potential risk of infection. Infection rates for surgical treatment of breast cancer are documented at between 3% and 15%, higher than average for a clean surgical procedure. Pre- and perioperative antibiotics have been found to be useful in lowering infection rates in other surgical groups, yet there is no consensus on the use of prophylactic antibiotics for breast cancer surgery. This is an update of a Cochrane Review first published in 2005 and last updated in 2014. OBJECTIVES:To determine the effects of prophylactic (pre- or perioperative) antibiotics on the incidence of surgical site infection (SSI) after breast cancer surgery. SEARCH METHODS:For this fourth update, in August 2018 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE (including In-Process & Other Non-Indexed Citations); Ovid Embase; and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA:We included randomised controlled trials of pre- and perioperative antibiotics for patients undergoing surgery for breast cancer. Primary outcomes were rates of surgical site infection (SSI) and adverse reactions. DATA COLLECTION AND ANALYSIS:Three review authors independently examined the title and abstracts of all studies identified by the search strategy, then assessed study quality and extracted data from those that met the inclusion criteria. We contacted study authors to obtain missing information. We evaluated the certainty of evidence using the GRADE approach. We used standard methodological procedures expected by Cochrane. MAIN RESULTS:A total of 11 randomised controlled trials (2867 participants) were included in the review. No new studies were identified in this update. All studies included breast cancer patients and were based in the hospital setting. Ten studies evaluated preoperative antibiotic compared with no antibiotic or placebo. One study evaluated perioperative antibiotic compared with placebo or no antibiotic. Pooling of the results demonstrated that prophylactic antibiotics administered preoperatively probably reduce the incidence of SSI for patients undergoing breast cancer surgery without reconstruction (pooled risk ratio (RR) 0.67, 95% confidence interval (CI) 0.53 to 0.85; moderate certainty evidence). Anticipated absolute effects were calculated for the outcome incidence of SSI; 105 per 1000 for the none or placebo group and 71 per 1000 (95% CI 56 to 89) for the preoperative antibiotic prophylaxis group. Analysis of the single study comparing perioperative antibiotic with no antibiotic was inconclusive for incidence of SSI (RR 0.11, 95% CI 0.01 to 1.95; very low certainty evidence). No studies presented separate data for patients who underwent reconstructive surgery at the time of removal of the breast tumour.Secondary outcomes were not consistently included in the studies investigating preoperative antibiotic prophylaxis. It is very uncertain whether there is a difference in incidence of adverse events between the treatment and no treatment or placebo groups (10 studies, 2818 participants); very low certainty evidence downgraded one level for serious risk of bias, one level for serious inconsistency and one level for serious imprecision. It is unclear whether there is a difference in time to onset of infection between the treatment and no treatment or placebo groups (4 studies, 1450 participants); low certainty evidence downgraded one level for serious risk of bias and one level for serious inconsistency. It is unclear whether there is a difference in rates of readmission to hospital between the treatment and placebo groups (3 studies, 784 participants); low certainty evidence downgraded one level for serious inconsistency and one level for serious risk of bias. It is unclear whether there is a difference in cost of care between the treatment and no treatment or placebo groups (2 studies, 510 participants); low certainty evidence downgraded one level for serious risk of bias and one level for serious inconsistency. No analysable secondary outcome data were reported for the single study evaluating perioperative antibiotics. AUTHORS' CONCLUSIONS:Prophylactic antibiotics administered preoperatively probably reduce the risk of SSI in patients undergoing surgery for breast cancer. However, it is very uncertain whether there is an effect on incidence of adverse events. Furthermore, the effects on time to onset of infection, readmission to hospital and cost of care remain unclear. Further studies are required to establish the best protocols for clinical practice.

authors

Gallagher M,Jones DJ,Bell-Syer SV

doi

10.1002/14651858.CD005360.pub5

subject

Has Abstract

pub_date

2019-09-26 00:00:00

pages

CD005360

issn

1469-493X

journal_volume

9

pub_type

杂志文章
  • Interventions for chronic abacterial prostatitis.

    abstract:BACKGROUND:Chronic abacterial prostatitis is a common disabling but enigmatic condition with a symptom complex of pelvic area pain and lower urinary tract symptoms. The scope of treatments recommended for chronic abacterial prostatitis is a testament to how little is known about what causes the condition and how to tre...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002080

    authors: McNaughton C,Mac Donald R,Wilt T

    更新日期:2001-01-01 00:00:00

  • Olanzapine alone or in combination for acute mania.

    abstract:BACKGROUND:Olanzapine, an atypical antipsychotic, is used in the treatment of mania both as monotherapy and combined with other medicines. OBJECTIVES:To review the efficacy and tolerability of olanzapine in the treatment of mania SEARCH STRATEGY:The Cochrane Collaboration Depression, Anxiety and Neurosis Controlled T...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004040

    authors: Rendell JM,Gijsman HJ,Keck P,Goodwin GM,Geddes JR

    更新日期:2003-01-01 00:00:00

  • Azoles for allergic bronchopulmonary aspergillosis associated with asthma.

    abstract:BACKGROUND:Allergic bronchopulmonary aspergillosis is hypersensitivity to the fungus Aspergillus fumigatus that complicates patients with asthma and cystic fibrosis. The mainstay of treatment for allergic bronchopulmonary aspergillosis remains oral corticosteroids, though this does not completely prevent exacerbations ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001108.pub2

    authors: Wark PA,Gibson PG,Wilson AJ

    更新日期:2004-01-01 00:00:00

  • Femoral nerve blocks for acute postoperative pain after knee replacement surgery.

    abstract:BACKGROUND:Total knee replacement (TKR) is a common and often painful operation. Femoral nerve block (FNB) is frequently used for postoperative analgesia. OBJECTIVES:To evaluate the benefits and risks of FNB used as a postoperative analgesic technique relative to other analgesic techniques among adults undergoing TKR....

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD009941.pub2

    authors: Chan EY,Fransen M,Parker DA,Assam PN,Chua N

    更新日期:2014-05-13 00:00:00

  • Intravenous midazolam infusion for sedation of infants in the neonatal intensive care unit.

    abstract:BACKGROUND:The need for sedation for neonates undergoing uncomfortable procedures in the neonatal intensive care unit (NICU) has often been overlooked. Proper sedation may reduce stress and avoid complications during procedures such as mechanical ventilation. Midazolam is a short acting benzodiazepine that has been inc...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002052

    authors: Ng E,Taddio A,Ohlsson A

    更新日期:2000-01-01 00:00:00

  • Interventions for rosacea.

    abstract:BACKGROUND:Rosacea is a common skin condition affecting the face, characterised by flushing, redness, pimples, pustules and dilated blood vessels. The eyes are often also involved. The cause of rosacea is unclear. It is a chronic disease, which can be controlled in most cases with appropriate treatment. Numerous treatm...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003262.pub2

    authors: van Zuuren EJ,Graber MA,Hollis S,Chaudhry M,Gupta AK

    更新日期:2004-01-01 00:00:00

  • Pre-admission antibiotics for suspected cases of meningococcal disease.

    abstract:BACKGROUND:Meningococcal disease begins suddenly and death can follow within hours. Pre-admission antibiotic therapy aims to prevent delay in starting therapy that occurs if bacterial confirmation is sought before instituting therapy. OBJECTIVES:To study the effectiveness and safety of pre-admission antibiotics versus...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD005437.pub2

    authors: Sudarsanam T,Rupali P,Tharyan P,Abraham OC,Thomas K

    更新日期:2008-01-23 00:00:00

  • Chinese herbal medicines for threatened miscarriage.

    abstract:BACKGROUND:Threatened miscarriage occurs in 10% to 15% of all pregnancies. Vaginal spotting or bleeding during early gestation is common, with nearly half of those pregnancies resulting in pregnancy loss. To date, there is no effective preventive treatment for threatened miscarriage. Chinese herbal medicines have been ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD008510.pub2

    authors: Li L,Dou L,Leung PC,Wang CC

    更新日期:2012-05-16 00:00:00

  • Nutritional support in children and young people with cancer undergoing chemotherapy.

    abstract:BACKGROUND:It is well documented that malnutrition is a common complication of paediatric malignancy and its treatment. Malnutrition can often be a consequence of cancer itself or a result of chemotherapy. Nutritional support aims to reverse malnutrition seen at diagnosis, prevent malnutrition associated with treatment...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003298.pub3

    authors: Ward EJ,Henry LM,Friend AJ,Wilkins S,Phillips RS

    更新日期:2015-08-24 00:00:00

  • Bile acids for primary sclerosing cholangitis.

    abstract:BACKGROUND:Bile acids have been used for treating primary sclerosing cholangitis, but their beneficial and harmful effects remain unclear. OBJECTIVES:To assess the beneficial and harmful effects of bile acids for patients with primary sclerosing cholangitis. SEARCH STRATEGY:We searched The Cochrane Hepato-Biliary Gro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003626

    authors: Chen W,Gluud C

    更新日期:2003-01-01 00:00:00

  • Radical radiotherapy for stage I/II non-small cell lung cancer in patients not sufficiently fit for or declining surgery (medically inoperable).

    abstract:BACKGROUND:In general, surgery is believed to offer the best prospects for cure for early stage non-small cell lung cancer (NSCLC). In spite of the intention to consider all patients with stage I-II disease for surgery, there are those who, although technically operable, either refuse surgery or are considered inoperab...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002935

    authors: Rowell NP,Williams CJ

    更新日期:2001-01-01 00:00:00

  • Servo-control for maintaining abdominal skin temperature at 36C in low birth weight infants.

    abstract:BACKGROUND:Randomized trials have shown that the neonatal mortality rate of low birth-weight babies can be reduced by keeping them warm. For low birth-weight babies nursed in incubators, warm conditions may be achieved either by heating the air to a desired temperature, or by servo-controlling the baby's body temperatu...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD001074

    authors: Sinclair JC

    更新日期:2002-01-01 00:00:00

  • Steroids for idiopathic sudden sensorineural hearing loss.

    abstract:BACKGROUND:This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 2006 and previously updated in 2009.Idiopathic sudden sensorineural hearing loss (ISSHL) is a clinical diagnosis characterised by a sudden deafness of cochlear or retrocochlear origin in the absence of a clear precipit...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD003998.pub3

    authors: Wei BP,Stathopoulos D,O'Leary S

    更新日期:2013-07-02 00:00:00

  • Angiogenesis-inhibitors for metastatic thyroid cancer.

    abstract:BACKGROUND:Systemic cytostatic therapies for advanced, metastatic thyroid carcinomas have been poorly effective. Tumor growth and metastasis depend on blood supply and blood vessel formation (angiogenesis). Therefore, inhibition of angiogenesis may represent a promising target for cancer therapy. OBJECTIVES:To evaluat...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007958.pub2

    authors: Tan A,Xia N,Gao F,Mo Z,Cao Y

    更新日期:2010-03-17 00:00:00

  • Interventions for cough in cancer.

    abstract:BACKGROUND:Cough is a common symptom in patients with malignancies, especially in patients with lung cancer. Cough is not well controlled in clinical practice and clinicians have few management options to treat it. OBJECTIVES:The primary objective of this review was to determine the effectiveness of interventions, bot...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007881.pub2

    authors: Molassiotis A,Bailey C,Caress A,Brunton L,Smith J

    更新日期:2010-09-08 00:00:00

  • Transcutaneous carbon dioxide monitoring for the prevention of neonatal morbidity and mortality.

    abstract:BACKGROUND:Carbon dioxide (CO2) measurement is a fundamental evaluation in a neonatal intensive care unit (NICU), as both low and high values of CO2 might have detrimental effects on neonatal morbidity and mortality. Though measurement of CO2 in the arterial blood gas is the most accurate way to assess the amount of CO...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD011494.pub2

    authors: Bruschettini M,Romantsik O,Zappettini S,Ramenghi LA,Calevo MG

    更新日期:2016-02-13 00:00:00

  • Immediate versus deferred delivery of the preterm baby with suspected fetal compromise for improving outcomes.

    abstract:BACKGROUND:Immediate delivery of the preterm fetus with suspected compromise may decrease the risk of damage due to intrauterine hypoxia. However, it may also increase the risks of prematurity. OBJECTIVES:To assess the effects of immediate versus deferred delivery of preterm babies with suspected fetal compromise on n...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD008968.pub2

    authors: Stock SJ,Bricker L,Norman JE

    更新日期:2012-07-11 00:00:00

  • Combination fluticasone and salmeterol versus fixed dose combination budesonide and formoterol for chronic asthma in adults and children.

    abstract:BACKGROUND:Combination therapies are frequently recommended as maintenance therapy for people with asthma, whose disease is not adequately controlled with inhaled steroids. Fluticasone/salmeterol (FP/SAL) and budesonide/formoterol (BUD/F) have been assessed against their respective monocomponents, but there is a need t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004106.pub3

    authors: Lasserson TJ,Cates CJ,Ferrara G,Casali L

    更新日期:2008-07-16 00:00:00

  • Optimal primary surgical treatment for advanced epithelial ovarian cancer.

    abstract:BACKGROUND:Ovarian cancer is the sixth most common cancer among women. In addition to diagnosis and staging, primary surgery is performed to achieve optimal cytoreduction (surgical efforts aimed at removing the bulk of the tumour) as the amount of residual tumour is one of the most important prognostic factors for surv...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD007565.pub2

    authors: Elattar A,Bryant A,Winter-Roach BA,Hatem M,Naik R

    更新日期:2011-08-10 00:00:00

  • Endovenous ablation (radiofrequency and laser) and foam sclerotherapy versus conventional surgery for great saphenous vein varices.

    abstract:BACKGROUND:Minimally invasive techniques to treat great saphenous varicose veins include ultrasound-guided foam sclerotherapy (USGFS), radiofrequency ablation (RFA) and endovenous laser therapy (EVLT). Compared with conventional surgery (high ligation and stripping (HL/S)), proposed benefits include fewer complications...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005624.pub2

    authors: Nesbitt C,Eifell RK,Coyne P,Badri H,Bhattacharya V,Stansby G

    更新日期:2011-10-05 00:00:00

  • Extracorporeal membrane oxygenation for severe respiratory failure in newborn infants.

    abstract:BACKGROUND:Neonatal extracorporeal membrane oxygenation (ECMO) is a complex procedure of life support used in severe but potentially reversible respiratory failure in term infants. Although the number of babies eligible for ECMO is small and the use of ECMO invasive and potentially expensive, its benefits may be high. ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD001340.pub2

    authors: Mugford M,Elbourne D,Field D

    更新日期:2008-07-16 00:00:00

  • Corticosteroids for chronic inflammatory demyelinating polyradiculoneuropathy.

    abstract:BACKGROUND:Chronic inflammatory demyelinating polyradiculoneuropathy is a peripheral neuropathy caused by peripheral nerve inflammation probably due to autoimmunity and would be expected to benefit from corticosteroids. Non-randomised studies suggest that corticosteroids are often beneficial. OBJECTIVES:To evaluate th...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD002062

    authors: Mehndiratta MM,Hughes RA

    更新日期:2002-01-01 00:00:00

  • Hyperbaric oxygen therapy for chronic wounds.

    abstract:BACKGROUND:Chronic wounds are common and present a health problem with significant effect on quality of life. Various pathologies may cause tissue breakdown, including poor blood supply resulting in inadequate oxygenation of the wound bed. Hyperbaric oxygen therapy (HBOT) has been suggested to improve oxygen supply to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004123.pub3

    authors: Kranke P,Bennett MH,Martyn-St James M,Schnabel A,Debus SE

    更新日期:2012-04-18 00:00:00

  • Total versus subtotal hysterectomy for benign gynaecological conditions.

    abstract:BACKGROUND:Hysterectomy using an abdominal approach removes either the uterus alone (subtotal hysterectomy) or both the uterus and the cervix (total hysterectomy). The latter is more common but outcomes have not been systematically compared. OBJECTIVES:To assess and compare outcomes with subtotal hysterectomy versus t...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD004993.pub2

    authors: Lethaby A,Ivanova V,Johnson NP

    更新日期:2006-04-19 00:00:00

  • Inhaled corticosteroids for stable chronic obstructive pulmonary disease.

    abstract:BACKGROUND:The role of inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD) has been the subject of much controversy. Major international guidelines recommend selective use of ICS. Recently published meta-analyses have reported conflicting findings on the effects of inhaled steroid therapy in C...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD002991.pub2

    authors: Yang IA,Fong KM,Sim EH,Black PN,Lasserson TJ

    更新日期:2007-04-18 00:00:00

  • Interferon beta for secondary progressive multiple sclerosis.

    abstract:BACKGROUND:Therapy with either recombinant beta-1a or beta-1b interferons (IFNs) is worldwide approved for Relapsing Remitting Multiple Sclerosis (RRMS). A major unanswered question is whether this treatment is able to safely reverse or retard the progressive phase of the disease. OBJECTIVES:The main objective was to ...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD005181.pub3

    authors: La Mantia L,Vacchi L,Di Pietrantonj C,Ebers G,Rovaris M,Fredrikson S,Filippini G

    更新日期:2012-01-18 00:00:00

  • Face-to-face interventions for informing or educating parents about early childhood vaccination.

    abstract:BACKGROUND:Early childhood vaccination is an essential global public health practice that saves two to three million lives each year, but many children do not receive all the recommended vaccines. To achieve and maintain appropriate coverage rates, vaccination programmes rely on people having sufficient awareness and a...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,meta分析,评审

    doi:10.1002/14651858.CD010038.pub3

    authors: Kaufman J,Ryan R,Walsh L,Horey D,Leask J,Robinson P,Hill S

    更新日期:2018-05-08 00:00:00

  • WITHDRAWN: Interventions for treating hallux valgus (abductovalgus) and bunions.

    abstract:BACKGROUND:Hallux valgus is classified as an abnormal deviation of the great toe (hallux) towards the midline of the foot. OBJECTIVES:To identify and evaluate the evidence from randomised trials of interventions used to correct hallux valgus. SEARCH STRATEGY:We searched the Cochrane Bone, Joint and Muscle Trauama Gro...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD000964.pub3

    authors: Ferrari J,Higgins JP,Prior TD

    更新日期:2009-04-15 00:00:00

  • Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa.

    abstract:BACKGROUND:Malignant, or necrotising, otitis externa is a potentially fatal infection of the external ear canal and surrounding soft tissue and bone. It may be complicated by involvement of cranial nerves, principally the facial nerves and the contents of the jugular foramen. It is an uncommon condition mainly found in...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD004617.pub3

    authors: Phillips JS,Jones SE

    更新日期:2013-05-31 00:00:00

  • Honey and lozenges for children with non-specific cough.

    abstract:BACKGROUND:Chronic non-specific cough is a chronic, dry cough of in the absence of identifiable respiratory disease or known aetiology. Although it is usually not reflective of an underlying severe illness, it does cause significant morbidity, and as such relief from it is often sought. The use of honey and lozenges to...

    journal_title:The Cochrane database of systematic reviews

    pub_type: 杂志文章,评审

    doi:10.1002/14651858.CD007523.pub2

    authors: Mulholland S,Chang AB

    更新日期:2009-04-15 00:00:00