Evidence map›Paper›PMID 39780234›Full record

SynthesisSystematic reviews2025

Synthesizing evidence to guide the design and implementation of effective strategies for discontinuing postoperative antibiotic prophylaxis in surgical settings: an umbrella review post-WHO 2018 recommendations.

George Msema Bwire, Renatus B Magati, Hafidhi H Ntissi, Tusaligwe Mbilinyi, Martine A Manguzu, Goodluck G Nyondo, Belinda J Njiro, Lilian B Nkinda, Castory G Munishi, Obadia Nyongole and 2 more

Abstract readSystematic Review
In one paragraph

Synthesis in Systematic reviews, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

George Msema BwireDepartment of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Renatus B MagatiDepartment of Clinical Nursing, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
Hafidhi H NtissiDepartment of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Tusaligwe MbilinyiDepartment of Pharmaceutical Microbiology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Martine A ManguzuDepartment of Clinical Pharmacy and Pharmacology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Goodluck G NyondoDepartment of Medicinal Chemistry, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Belinda J NjiroDepartment of Epidemiology and Biostatistics, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Lilian B NkindaDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Castory G MunishiDepartment of Pharmaceutics and Pharmacy Practice, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Obadia NyongoleDepartment of Surgery, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.
Pacifique NdayishimiyeDepartment of Pharmacy, College of Medicine and Health Sciences, University of Rwanda, P.O. Box 4285, Kigali, Rwanda. pacimiye@gmail.com.ORCID 0000-0002-0277-1218
Mtebe V MajigoDepartment of Microbiology and Immunology, Muhimbili University of Health and Allied Science, Dar Es Salaam, Tanzania.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPostoperative antibiotic prophylaxis (PAP) involves using antibiotics after surgery to prevent surgical site infections (SSIs). However, studies have shown that PAP offers no additional benefits compared to discontinuation after surgical incision closure, prompting its de-implementation to prevent unnecessary antibiotic use that may contribute to antibiotic resistance. We conducted this review to synthesize evidence for guiding the design and implementation of effective strategies for discontinuing PAP practice and optimizing antibiotic use in surgical settings.

methodsThis umbrella review searched for articles from PubMed/MEDLINE and Scopus, focusing on reviews conducted on human subjects on PAP to prevent SSIs, published in English language from 2019 to 5th July 2024. This review followed guidelines from PRISMA-P and PRIOR. The risk of bias (methodological quality) was assessed using AMSTAR-2. The pooled risk ratio (RR) was estimated using a fixed-effects model (Mantel-Haenszel method), while I

resultsIn our umbrella review, we screened 1156 articles, with 28 review articles found eligible for final analysis, involving over 457 primary studies. About 80,483 patients were involved in 9 meta-analysis reviews, which were used to estimate the pooled RR. We found no significant benefits to patients from continuing PAP beyond 24-h post-surgery compared to immediate discontinuation, RR: 1.07 (95% CI: 0.97-1.17, I

conclusionsProlonging antibiotic prophylaxis beyond 24-h post-surgery did not show significant protective benefits against SSIs. Our findings support the 2018 WHO recommendation for the immediate discontinuation of PAP following surgical incision closure in clean and clean-contaminated procedures. Further de-implementation research studies are needed to guide the effective discontinuation of PAP practice.

Indexed as

Antibiotic ProphylaxisSurgical Wound InfectionAnti-Bacterial AgentsHumansPostoperative CarePractice Guidelines as TopicWorld Health OrganizationAnti-Bacterial AgentsBest practicePostoperative antibiotic prophylaxisStrategiesSurgical site infection

Identifiers

PMID39780234
PMCPMC11708070

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.