To evaluate the effectiveness of different antibiotic regimens in preventing surgical site infections (SSIs) in elective colorectal surgery.
Approach:
Key Findings:
Broad-spectrum penicillins and cephalosporin-based combinations were the most effective in reducing SSI risk.
Broad-spectrum penicillins were associated with a 74% relative reduction in SSI risk.
They were also the only class linked to reduced all-cause mortality.
No significant differences in length of hospital stay or overall adverse event rates among most regimens.
Interpretation:
The findings highlight the importance of selecting appropriate antibiotic classes for prophylaxis in colorectal surgery, with broad-spectrum penicillins showing the most consistent efficacy.
Limitations:
Many comparisons were based on small trials with frequent risk of bias.
Inconsistent reporting of comorbidities and protocols limited subgroup analyses.
Conclusion:
Broad-spectrum penicillins and certain cephalosporin combinations may provide optimal SSI prevention, suggesting a need for guideline updates.
