Eficácia da antibioticoprofilaxia na prevenção de infecções do sítio cirúrgico: uma revisão sistemática.

Abstract

Introduction: Surgical Site Infection (SSI) is characterized by infections that arise in the location where the surgical procedure was performed, generally as a local complication of the operated area. In Brazil, these infections are classified as Healthcare-Associated Infections (HAIs) and represent 14% to 16% of hospital admissions. Thus, antibiotic prophylaxis could, in a certain way, help reduce the incidence of these infections.  

Objectives: To evaluate the effectiveness of antibiotic prophylaxis for preventing postoperative infection and identify the profiles of patients benefiting from this technique through outcomes after its use.  

Methodology: A systematic review was carried out using data from the PubMed and LILACS databases, searching for the terms "Surgery" and "antibiotic prophylaxis". The objective was to find studies that analyzed the incidence of infections at the surgical site. Randomized clinical trials that compared the use of antibiotics before or during surgery with control groups that did not receive this therapy were included.

Results: Seven randomized clinical trials met the inclusion criteria and demonstrated different risks of bias. The interventions analyzed were breast cancer surgery, laparoscopic cholecystectomy, elective colorectal surgery and routine periocular surgery. The trials involved 2216 patients. In breast cancer surgery, in two studies, the antibiotic did not demonstrate a significant difference between the control group. In laparoscopic cholecystectomy, the antibiotic, in one study, proved to be more effective than no prophylaxis, while two did not express prophylactic power. In elective colorectal surgery, there was no statistical difference between treatment arms for any of the outcomes. In routine periocular surgery, patients treated with topical antibiotic ointment had a lower risk of surgical site infection. Conclusions: In line with past reviews, antibiotic prophylaxis did not demonstrate efficacy in improving infection outcomes at different surgical sites. In order to offer better care, it does not seem to be a good strategy to offer antibiotics for prophylactic purposes to patients.