title: Ceftriaxone versus other cephalosporins for perioperative antibiotic prophylaxis: a meta-analysis of 43 randomized controlled trials.
abstract: The efficacy of ceftriaxone versus other cephalosporins in the perioperative prophylaxis of surgical wound, urinary tract and respiratory tract infections was compared in a meta-analysis of randomized controlled trials published between 1986 and 1996, identified from the Medline, Embase, SIGLE, ROPU, DHSS-Data and Medikat Cologne databases. Studies were grouped by type of infection, operative specialty, wound classification, study quality and other factors, and assessed for relative risk (RR). Forty-three studies with a total of 13,482 patients met our inclusion criteria. RR for surgical wound infection (n = 13,303 patients) was 30% lower in the ceftriaxone versus control groups [98.3% confidence interval (CI): 0.55-0.89; p = 0.0002]. In urinary tract infections (n = 8,865 patients), the primary analysis of all studies showed marked superiority for ceftriaxone (RR: 0.53; 98.3% CI: 0.43-0.67) but not in studies with CDC-defined infections (RR: 0.63; 98.3% CI: 0.36-1.12). In both types of infection, ceftriaxone was superior in contaminated operations. The data showed no advantage for ceftriaxone in other operations. In respiratory tract infections (n = 9,567 patients), there was no significant difference: the RR was 0.81 (98.3% CI: 0.61-1.09; p = 0.04).
authors.affiliation: Institute of Environmental Medicine and Hospital Epidemiology, Freiburg University Hospital, Germany.
authors.forename: Eva Susanne
authors.initials: ES
authors.lastname: Dietrich
authors.forename: Ute
authors.initials: U
authors.lastname: Bieser
authors.forename: Uwe
authors.initials: U
authors.lastname: Frank
authors.forename: Guido
authors.initials: G
authors.lastname: Schwarzer
authors.forename: Franz D
authors.initials: FD
authors.lastname: Daschner
mesh_terms: D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D006801:Humans; D016017:Odds Ratio; D011300:Preoperative Care / Q000379:methods; D016032:Randomized Controlled Trials as Topic; D012141:Respiratory Tract Infections / Q000517:prevention & control; D012307:Risk Factors; D013530:Surgical Wound Infection / Q000517:prevention & control; D014552:Urinary Tract Infections / Q000517:prevention & control*
chemical_list: D002511:Cephalosporins; D002443:Ceftriaxone