title: A review of prophylactic antibiotics use in plastic surgery in China and a systematic review.
abstract: The purpose of this study was to investigate the use of antibiotic prophylaxis for plastic surgical procedures at our hospital, and to perform a systematic literature review of randomized controlled trials evaluating the use of prophylactic antibiotics in plastic surgery. The records of patients who received plastic surgical procedures with Class I surgical incisions between 2009 and 2010 were retrospectively reviewed. A systematic literature review was conducted for studies examining the use of prophylactic antibiotics for Class I surgical wounds. A total of 13,997 cases with Class I surgical incisions were included. Prophylactic antibiotics were given in 13,865 cases (99.1%). The antibiotics used were primarily cefuroxime, clindamycin, metronidazole, cefoxitin sodium, and gentamicin. The average duration of administration was 4.84 ± 3.07 (range, 1-51) days. Antibiotics were administered postoperatively in >99% of cases while preoperative antibiotic administration was only given in 32 cases (0.23%). Wound infections occurred in 21 cases for an overall infection rate of 0.15%. Fourteen studies met the inclusion criteria of the systematic review. There was marked variation in the timing of antibiotic administration with antibiotics given pre-, peri-, and postoperatively. Of studies that compared the use of prophylactic antibiotics with placebo, a reduction in wound infections was noted in 4 trials and no difference was noted in 6 trials. No significant difference in infection rates was shown between the prophylactic and postoperative arms. In conclusion, prophylactic antibiotics are overused in plastic surgical procedures. Evidence-based guidelines for the use of prophylactic antibiotics in plastic surgical procedures are needed.
authors.affiliation: Office of Hospital Infection, Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China.
authors.forename: Ge-hong
authors.initials: GH
authors.lastname: Li
authors.affiliation: Head and Neck Department of Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Ba Da Chu Road, Shi Jing Shan District, Beijing 100144, China. Electronic address: 13701005958@163.com.
authors.forename: Dian-ju
authors.initials: DJ
authors.lastname: Hou
authors.affiliation: Office of Hospital Infection, Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China.
authors.forename: Hua-dong
authors.initials: HD
authors.lastname: Fu
authors.affiliation: Office of Hospital Infection, Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China.
authors.forename: Jing-ying
authors.initials: JY
authors.lastname: Guo
authors.affiliation: Office of Hospital Infection, Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China.
authors.forename: Xiao-bo
authors.initials: XB
authors.lastname: Guo
authors.affiliation: Health Information Department, Plastic Surgery Hospital Affiliated to the Chinese Academy of Medical Sciences and Peking Union Medical College, Shijingshan District, Beijing 100144, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Gong
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis; D002440:Cefoxitin / Q000008:administration & dosage; D002444:Cefuroxime / Q000008:administration & dosage; D002681:China; D002981:Clindamycin / Q000008:administration & dosage; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D013518:Surgery, Plastic
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D008795:Metronidazole; D002981:Clindamycin; D002440:Cefoxitin; D002444:Cefuroxime
keywords: Class I surgical wound; Infection; Prophylactic antibiotics