title: Antibiotic prophylaxis for hernia repair.
abstract: BACKGROUND
  The use of antibiotic prophylaxis for hernia repair is currently a controversial issue given the disparity among study results in this area.
  
  
  OBJECTIVE
  The objective of this systematic review was to clarify the effectiveness of antibiotic prophylaxis in reducing postoperative wound infection rates in elective open inguinal hernia repair.
  
  
  METHODS
  Searches in the Cochrane Colorectal Cancer Group specialized register were conducted crossing the terms herni* and inguinal or groin and the terms antimicr* or antibiot* , as free text and MeSH terms. A similar search in Medline (WebSPIRS from Silver Platter, January/1966 to March/2004) and Embase (1976 to December/2003) was conducted using the following terms: #1 antibiotic* or antimicrob* or anti infecti* or antiinfecti*; #2 prophyla* or prevent*; #3 #1 and #2; #4 clean and (surgery or tech* or proced*); #5 herni*; #6 (wound infection) and #4; #7 #3 and (#4 or #5 or #6). Reference lists of the included studies were checked to identify additional studies.
  
  
  METHODS
  Only randomized clinical trials were included.
  
  
  METHODS
  Eight randomized clinical trials were identified. Three of them used prosthetic material for hernia repair (hernioplasty) whereas the remaining studies did not (herniorraphy). Pooled and subgroup analysis were conducted depending on whether prosthetic material was or not used. A random effects model was used in the analysis.
  
  
  RESULTS
  The total number of patients included was 2907 (treatment group: 1421, control group: 1486). Overall infection rates were 2.88% and 4.3% in the prophylaxis and control groups, respectively (OR 0.65, 95%CI 0.35 - 1.21). The subgroup of patients with herniorrhaphy had infection rates of 3.78% and 4.87% in the prophylaxis and control groups, respectively (OR 0.84, 95%CI 0.53 - 1.34). The subgroup of patients with hernioplasty had infection rates of 1.2% and 3,3% in the prophylaxis and control groups, respectively (OR 0.28, 95%CI 0.02 - 3.14).
  
  
  CONCLUSIONS
  Based on the results of this meta-analysis, there was no clear evidence that routine administration of antibiotic prophylaxis for elective inguinal hernia repair reduced infection rates.
authors.affiliation: Victoria Balfé, 2 - 6 B, Burgos, Castilla y León, Spain, 09006. jsanchezman@medynet.com
authors.forename: F J
authors.initials: FJ
authors.lastname: Sanchez-Manuel
authors.forename: J L
authors.initials: JL
authors.lastname: Seco-Gil
mesh_terms: D019072:Antibiotic Prophylaxis; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000517:prevention & control*