Effectiveness of antibiotic prophylaxis prescribing for orthopedic surgery : a systematic review

Abstract

Background: Orthopedic surgery is a common branch of surgery related to musculoskeletal system. The prevalence of orthopedics has dramatically increased currently. Antibiotic Prophylaxis is the use of antibiotics aims to prevent surgical site infection. Surgical site infection is one of the most commonly acquired infections accounts for 38% of all infections. Objective: This systematic review aims to thoroughly review and interpret the previous studies that using randomized controlled trails to investigate the effectiveness of antibiotic prophylaxis in orthopedic surgery and make evidence-based recommendations. Methods: The data are from Ovid-Medline, Pub-Med and Science-Direct by using various combinations of key words: “Orthopedic surgery”, “antibiotic prophylaxis”, “Surgical site infection” Anti-bacterial Agents” and “antibiotic prescribing”. After selection, 9 studies were eligible and they were evaluated independently by using Jadad and Delphi list assessment scales. Only 2 studies were considered as a low risk of bias, the rest of the seven are grouped as high risks of bias. Findings: Current studies usually make comparison of preoperative and perioperative antibiotic prophylaxis by add the existence (or not) of continuous postoperative administration. Most of the studies are not placebo controlled and increased their weakness of recommendations. Based on the available evidence, it is effective to implement preoperative antibiotic to reduce the infection rate; however, no reliably evidence has been found on extra value of prescribing additional postoperative antibiotics. Conclusion: This study evaluated the previous RCTs studies and assessed the effectiveness of antibiotic prophylactic prescribing, it is necessary to enhance more low risk of bias studies appeared to provide more evidence.