Efficacy of different durations of perioperative antibiotics to prevent surgical site infection after spinal surgery: a network Meta-analysis

English Keywords:spine  antibiotics  duration  surgical site infection  network Meta-analysis

English Abstract:

  【Abstract】 Objectives: To investigate the efficacy of different durations of perioperative antibiotics to prevent surgical site infection after spinal surgery. Methods: PubMed, Embase, The Cochrane Library, CNKI, VIP and WanFang databases were electronically searched to collect clinical studies about different durations of perioperative prophylactic antibiotics for reducing the SSI rate after spinal surgery. The design of studies included randomized controlled trials(RCTs) and cohort studies(CSs). Retrieval time was from January 1, 2000 to May 4, 2020. Two reviewers independently screened literature, extracted data and assessed the quality of included studies following the inclusion and exclusion criteria. The durations of antibiotics were divided into single-dose group, postoperative 24h group, postoperative 48h group and postoperative over 48h group. Network Meta-analysis was conducted in STATA 14 software to compare the efficacy of different durations of perioperative antibiotic for reducing the SSI rate after spinal surgery. Results: Ten studies were eligible for this analysis including 5 RCTs, 2 prospective cohort studies and 3 retrospective cohort studies. Four durations of antibiotics were involved (single-dose, postoperative 24h, postoperative 48h, postoperative over 48h). For network Meta-analysis, postoperative 24h group [RR=0.48, 95%CI (0.23,0.99)] and postoperative over 48h group [RR=0.52, 95%CI (0.32,0.84)] were superior to single-dose group for reducing the SSI rate. The ranking results suggested that the efficacy of postoperative 24h group was better than other durations. Conclusions: The evidence shows that the efficacy of antibiotic duration of postoperative 24h is probably optimal.