title: Prophylactic use of gentamicin/flucloxacillin versus cefuroxime in surgery: a meta analysis of clinical studies.
abstract: OBJECTIVE
  To conduct meta-analyses of all available studies comparing efficacies of prophylactic cefuroxime and prophylactic gentamicin/flucloxacillin (Gen/Flu) in preventing post-operative wound infections and their association with risks of Clostridium difficile infections and post-operative renal impairment.
  
  
  METHODS
  Published studies including both prophylactic cefuroxime and prophylactic Gen/Flu used in surgery were included for meta analysis. Outcomes were analyzed using a random-effect model or a fixed-effect model depending on the heterogeneity across the included studies.
  
  
  RESULTS
  Gen/Flu prophylaxis showed similar efficacy as cefuroxime prophylaxis in preventing post-operative wound infections and was associated with a significantly lower risk of Clostridium difficile infection, but it was associated with a higher risk of post-operative renal impairment, especially in orthopedic surgery.
  
  
  CONCLUSIONS
  Our findings that Gen/Flu prophylaxis was associated with significantly higher risk of post-operative renal impairment dictate that benefits and risks of Gen/Flu prophylaxis should be carefully assessed and balanced, and each patient should be evaluated individually so that a proper antibiotic prophylaxis regimen could be chosen.
authors.affiliation: Emergency Department, The Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
authors.forename: Shaoning
authors.initials: S
authors.lastname: Luo
authors.affiliation: Department of Gastroenterology, Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Lai
authors.affiliation: Emergency Department, The Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
authors.forename: Chunxin
authors.initials: C
authors.lastname: Liu
authors.affiliation: Department of Breast Surgery, Sun Yat-Sen Menorial Hospital, Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Emergency Department, The Third Affiliated Hospital of Sun Yat-Sen University Tianhe District, Guangzhou 510000, China.
authors.forename: Xiaoyu
authors.initials: X
authors.lastname: Qiao
keywords: Cefuroxime; flucloxacillin; gentamicin; infection; meta-analysis; prophylaxis; surgery