title: A randomized trial of antibiotic prophylaxis for the prevention of surgical site infection after open mesh-plug hernia repair.
abstract: BACKGROUND
  The efficacy of antibiotic prophylaxis for the prevention of surgical-site infection (SSI) after open tension-free inguinal hernia repair remains controversial.
  
  
  METHODS
  A double-blind, randomized, placebo-controlled trial was conducted. Patients who underwent elective open mesh-plug hernia repair were eligible for randomization. In the antibiotic prophylaxis group, 1.0 g cefazolin was intravenously administrated 30 minutes before the incision. In the placebo group, an equal volume of sterile saline was administered. The primary end point was the incidence of SSI.
  
  
  RESULTS
  A total of 200 patients were enrolled. SSI developed in 2 of 100 patients (2%) in the antibiotic prophylaxis group and 13 of 100 patients (13%) in the placebo group, indicating a significant difference between the 2 groups (relative risk ratio, 0.25; 95% confidence interval, 0.070 to 0.92; P = .003). Other complications occurred in 23 patients: 7 (7%) in the antibiotic prophylaxis group and 16 (16%) in the placebo group (P = .046).
  
  
  CONCLUSIONS
  This study indicates that antibiotic prophylaxis is effective for the prevention of SSI after open mesh-plug hernia repair.
authors.affiliation: Department of Surgery, Nihon University School of Medicine, Tokyo, Japan. Electronic address: mazaki.takero@nihon-u.ac.jp.
authors.forename: Takero
authors.initials: T
authors.lastname: Mazaki
authors.affiliation: Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Mado
authors.affiliation: Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Masuda
authors.affiliation: Department of Surgery, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Motomi
authors.initials: M
authors.lastname: Shiono
authors.affiliation: Department of Pharmacy, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Noahiro
authors.initials: N
authors.lastname: Tochikura
authors.affiliation: Department of Pharmacy, Nihon University School of Medicine, Tokyo, Japan.
authors.forename: Morio
authors.initials: M
authors.lastname: Kaburagi
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002437:Cefazolin / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006552:Hernia, Inguinal / Q000601:surgery*; D059685:Herniorrhaphy / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D015994:Incidence; D007275:Injections, Intravenous; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013526:Surgical Mesh; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002437:Cefazolin
keywords: Antibiotic prophylaxis; Inguinal hernia; Mesh-plug; Repair; Surgical-site infection