Role of Prophylactic Antibiotics in Laparoscopic Cholecystectomy in Developing Country: A Meta-Analy

来源 :2014年中国药学大会暨第十四届中国药师周 | 被引量 : 0次 | 上传用户:raysparkle
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  Background: The role of routine antibiotic prophylaxis (ABP) in laparoscopic cholecystectomy(LC)for low-risk patients remains controversial and is not indicated in majority of clinical guidelines.However,the routine ABP was common used at clinical settings of LC,especially in the developing countries.To evaluate the efficacy of routine ABP in LC on low-risk patients of the developing countries,a meta-analysis was performed.Methods: We searched multiple databases from establish to July 2013.,The randomized controlled trials (RCTs) that compared perioperative ABP with control group (placebo or no antibiotics) on low-risk patients undergoing LC were searched.Then,24 studies fulfilled the selection criteria and Jadad scale was evaluated independently by three authors.10 RCTs (including 2561 patients) in developing countries were investigated for the meta-analysis.Random or fixed effects models were used by the I2.Funnel plot was used to assess publication bias according to the methods of Begg and Egger.Results: 10 RCTs included 2516 patients.The data of meta-analysis suggested that compared with the control group,there was no significant reduction in ABP group for overall infectious complications (OR=0.95,95%CI:0.58~1.55,I2=0%,P=0.84),superficial wound infectious complications(OR=0.87,95%CI:0.50~1.53,I2=0%,P=0.96),intra-abdominal infectious complications (OR=2.94,95%CI:0.30~28.49,I2=0%,P=0.99),distant infectious complications(OR=1.20,95%CI:0.45~3.20,I2=0%,P=0.64),positive bile bacteria cultures(OR=0.76,95%CI:0.53~1.09,I2=0%,P=0.97).However,prophylactic antibiotics prior to LC result in shorter length of hospital stay (WMD= -0.16,95%CI:-0.28~-0.03,I2=72%,P=0.0007).The sensitivity analyses were performed by different effect models and the results were consistent,indicating the robustness of the finding.Conclusions: Prophylactic antibiotic could not reduce the infectious complications,which suggested that it is unnecessary to use ABP for low-risk patients undergoing laparoscopic cholecystectomy.
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