Prophylactic antibiotics for mesh inguinal hernioplasty: a meta-analysis.
OBJECTIVE
To assess the effectiveness of antibiotic prophylaxis in mesh hernioplasty.


BACKGROUND
Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. Available evidence is nonconclusive because of the low number of clinical trials assessing its effectiveness. Some trials have a small sample size that could overestimate or underestimate the real effectiveness of this intervention. Meta-analysis is a good method to improve these methodological flaws.


METHODS
Meta-analysis intended to measure the benefits of antibiotic prophylaxis on surgical site infection rate in adult patients scheduled for mesh inguinal hernioplasty. Six randomized clinical trials were found. Quality was assessed using Cochrane Collaboration criteria.


RESULTS
A total of 2507 patients were analyzed. Surgical site infection frequency was 1.38% in the antibiotic group versus 2.89% in the control group (odds ratio = 0.48; 95% confidence interval, 0.27-0.85). There was no statistical heterogeneity. Sensitivity analysis by quality did not show differences in overall results.


CONCLUSIONS
Antibiotic prophylaxis use in patients submitted to mesh inguinal hernioplasty decreased the rate of surgical site infection by almost 50%.
Sanabria
Alvaro
A
Grupo Colaborativo de Epidemiología Quirúrgica, Department of Surgery, School of Medicine, Pontificia Universidad Javeriana-Hospital, Universitario San Ignacio, Bogotá, Colombia. alvarosanabria@gmail.com
Domínguez
Luis Carlos
LC
Valdivieso
Eduardo
E
Gómez
Gabriel
G
D019072:Antibiotic Prophylaxis; D006552:Hernia, Inguinal / Q000601:surgery*; D006801:Humans; D017594:Publication Bias / Q000706:statistics & numerical data; D016032:Randomized Controlled Trials as Topic; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000517:prevention & control*