Efficacy of antimicrobial prophylaxis on the risk of surgical site infections in companion animal surgery: a systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines.

Abstract

OBJECTIVES: Like all antimicrobial use, surgical antimicrobial prophylaxis should only be administered when the benefits outweigh potential harms. The aim of this systematic review and meta-analysis was to assess the effectiveness of surgical antimicrobial prophylaxis to reduce surgical site infections in dogs and cats. MATERIALS AND METHODS: Population, intervention, comparator and outcome were generated by a multidisciplinary guideline panel and clinical decision thresholds were derived from stakeholder interviews. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to evaluate the certainty of the evidence. RESULTS: Eight randomised controlled trials and seven observational studies met the eligibility criteria and were included in the review. Nine categories of surgical procedures were created based on organ system and wound classification and outcomes included surgical site infections, adverse events and mortality. Very low to moderate certainty evidence showed that surgical antimicrobial prophylaxis only had a trivial or small clinical effect on surgical site infection incidence in all surgical procedures. No adverse effects or mortalities related to surgical site infections were reported in any of the studies. CLINICAL SIGNIFICANCE: The results of this study will be used to create evidence-based treatment guidelines.