Takeaway
- This meta-analysis suggests that extended postoperative antibiotic therapy vs no postoperative antibiotic therapy is not associated with improved postoperative infectious or non-infectious outcomes in patients with mild or moderate acute calculous cholecystitis undergoing emergency cholecystectomy.
Why this matters
- Findings suggest that postoperative antibiotics should not be routinely used and should be preserved only for selected cases.
Study design
- Four randomised controlled trials involving 953 patients met eligibility criteria after a search on MEDLINE, EMBASE, CINAHL, and the Cochrane Central Register of Controlled Trials.
- Primary outcome: postoperative infectious complications and surgical site infections (SSIs).
- Funding: None disclosed.
Key results
- Baseline characteristics were comparable in the extended antibiotic group and no antibiotic group.
- Mean operative time was longer in the extended antibiotic group (79.9 vs 72.3; mean difference [MD], 5.40; 95% CI, 1.80-9.01; P=.003).
- No difference was observed between the two groups in:
- postoperative infectious complications (OR, 0.94; P=.79)
- SSIs (OR, 1.13; P=.72)
- postoperative morbidity (OR, 0.93; P=.70)
- postoperative non-infectious complications (OR, 0.85; P=.57)
- urinary tract infections (OR, 0.69; P=.55)
- pneumonia (OR, 0.33; P=.14)
- length of hospital stay (MD, 0.78; P=.25)
- postoperative mortality (risk difference, −0.00; P=.65) and
- need for readmission (OR, 0.87; P=.70).
Limitations
- Small number of studies
References
References
