ReviewAntibiotics (Basel, Switzerland)2025
The Impact of Antibiotic Prophylaxis on Antibiotic Resistance, Clinical Outcomes, and Costs in Adult Hemato-Oncological and Surgical Patients: A Systematic Review and Meta-Analysis.
Review in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Improving Empiric Antibiotic Selection for Patients With Cancer Hospitalized With Infection: Secondary Analysis of the INSPIRE Cluster Randomized Trials.JAMA network open · 2026Trial
- Article
- Physician Antibiotic Prescribing Preferences in Community Acquired Pneumonia and Complicated Urinary Tract Infections: A National Discrete Choice Experiment.Open forum infectious diseases · 2026Article
- Antibiotic Use in Surgical Wards: A Point Prevalence Survey Based on the WHO AWaRe Methodology.Antibiotics (Basel, Switzerland) · 2025Article
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Authors and funding
6 authors.
Funding
Abstract
BACKGROUND/
objectivesWhile antibiotic prophylaxis is crucial for preventing infections, its impact on the development of antibiotic-resistant infections and clinical outcomes remains underexplored. We aimed to systematically assess the impact of medical and surgical antibiotic prophylaxis (SAP) on the development of antibiotic-resistant infections, clinical outcomes, and costs.
methodsA systematic review and meta-analysis of the effect of antibiotic prophylaxis on antibiotic-resistant infections, mortality, length of hospital stay, and/or costs was conducted in hemato-oncological or surgical patient populations. Pooled estimates of the relative risk (RR) or weighted mean difference (WMD) were derived using random-effect meta-analysis.
resultsOf 10,409 screened studies, 109 (30%) comprising 131,519 patients were included. In 55 hemato-oncological studies, prophylaxis significantly reduced Gram-negative infections (RR: 0.51; 95% CI: 0.45 to 0.59) without an effect on mortality (RR = 1.01; 95% CI: 0.89 to 1.15), while the risk of developing an infection resistant to prophylactic antibiotics during hospitalization was doubled (RR: 2.05; 95% CI: 1.88 to 2.23). The length of hospitalization was reduced by 1.85 days. Among 54 surgical studies, SAP lowered surgical-site infections (RR: 0.58; 95% CI: 0.49 to 0.69). Extending prophylaxis beyond the recommended duration did not improve infection rates (RR: 1.10; 95% CI: 0.98 to 1.24). No association was demonstrated between prophylaxis adjusted by colonization status and the development of resistant infections.
conclusionThough proven beneficial, our results highlight the critical need for targeted antibiotic stewardship programs (ASPs) in both settings. A meticulous risk assessment balancing the benefits of preventing life-threatening infections against the risk of driving antimicrobial resistance, and a tailored ASP, is urgently needed for hemato-oncological patients.
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