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Abstract: FR-PO1158

Perioperative Antibiotics for Preventing Post-Surgical Site Infections in Solid Organ Transplant Recipients

Session Information

Category: Transplantation

  • 1902 Transplantation: Clinical

Authors

  • Chan, Samuel Shun-Kwan, Department of Nephrology, Princess Alexandra Hospital, Metro South Hospital and Health Service, Woollongabba, Queensland, Australia
  • Ng, Samantha, C/o, Spring Hill, Queensland, Australia
  • Hawley, Carmel, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Pascoe, Elaine, The University of Queensland, New Farm, New South Wales, Australia
  • Chan, Hooi peng, General Practice, Brisbane, New South Wales, Australia
  • Playford, Geoffrey, Princess Alexaandra Hospital, Woolloongabba, New South Wales, Australia
  • Wong, Germaine, The University of Sydney, Sydney, New South Wales, Australia
  • Chapman, Jeremy R., Westmead Hospital, Westmead, New South Wales, Australia
  • Lim, Wai Hon, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
  • Francis, Ross Simon, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Isbel, Nicole, Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Campbell, Scott B., Princess Alexandra Hospital, Brisbane, Queensland, Australia
  • Johnson, David W., Princess Alexandra Hospital, Brisbane, Queensland, Australia

Group or Team Name

  • Australasian Kidney Trials Network
Background

No consensus exists on the role of antibiotics for preventing surgical site infections (SSIs) in solid organ transplant recipients (SOTRs). Objectives: To assess the benefits and harms of prophylactic antibiotics for preventing SSIs in SOTRs.

Methods

The Cochrane Kidney and Transplant Register was searched up to 8 Dec 2018. Studies were identified through searches of CENTRAL, MEDLINE, EMBASE, conference proceedings, International Clinical Trials Register (ICTRP) Search Portal, and ClinicalTrials.gov. All randomized controlled trials (RCTs) and quasi RCTs in any language assessing prophylactic antibiotics for preventing SSIs in SOTRs at any time point after transplantation. Two authors independently determined study eligibility, assessed quality and extracted data. The primary outcome was SSI incidence. Summary effect estimates were obtained using a random-effects model and results were expressed as risk ratios (RR) and 95% confidence intervals (CI) for categorical variables, and mean differences (MD) or standardized mean differences (SMD) and 95% CI for continuous variables.

Results

This review included 9 eligible studies (803 participants). Six studies (416 participants) compared antibiotics versus no antibiotics and 3 studies (387 participants) compared extended duration antibiotics versus short duration antibiotics. Risk of bias was assessed as high for performance (9 studies), detection (9 studies), attrition (2 studies) and selective outcome reporting (1 study). Antibiotics had an uncertain effect on SSI incidence (RR 0.63, 95%CI 0.37-1.06; 6 studies, 416 participants, I2=61%, very low certainty evidence). Most RCTs occurred prior to 200 (RR 2.17, 95%CI 0.84-5.66; 1 study, 188 participants, very low certainty evidence) with only 1 RCT in the last 2 decades (RR 0.30, 95%CI 0.15-0.60; 5 studies, 228 participants, I2=33%, very low certainty evidence).

Conclusion

There is very low certainty evidence to support perioperative antibiotics for preventing SSIs in SOTRs. Further high quality, adequately powered RCTs would better inform practice.

Funding

  • Other U.S. Government Support