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Abstract：
BACKGROUND: Prophylactic antibiotics are traditionally given as a single dose for caesarean section. However, inconsistent application of recommendations and recent evidence prompted a literature review.
OBJECTIVE: To assess the optimal regimen for antibiotic prophylaxis in caesarean section by comparing single versus multiple doses of the same intervention.
METHODS: MEDLINE, Web of Knowledge, SCOPUS, CENTRAL and ongoing trials databases were searched. Reference lists were reviewed and international groups contacted.
METHODS: Randomised controlled trials (RCT) comparing single with multiple dose regimens of the same antibiotic prophylaxis. Quasi-RCT and abstracts were suitable for inclusion.
METHODS: Reviewers independently extracted data and assessed quality of evidence. A random-effects model was used and results presented as risk ratio (RR) with 95% confidence intervals (CI).
RESULTS: Sixteen studies were included, involving 2695 women. Nonsignificant differences were observed between single dose and multiple dose antibiotic prophylaxis in the incidence of postpartum infectious morbidity (RR 0.95, 95% CI 0.75-1.20, I2 = 25%), endometritis (RR 1.03, 95% CI 0.74-1.42, I2 = 0%) and wound infection (RR 1.22, 95% CI 0.72-2.08, I2 = 0%). A trend towards lower risk of urinary tract infection was seen with multiple dose (RR 0.65, 95% CI 0.34-1.24, I2 = 0%).
CONCLUSIONS: There was insufficient evidence to determine whether there is a difference between single and multiple dose regimens in reducing the incidence of infectious morbidity after caesarean section. The quality of evidence was very low and well-designed RCTs are needed.
CONCLUSIONS: Insufficient evidence of difference between dosage regimens of antibiotic prophylaxis in caesarean section.
OBJECTIVE: To assess the optimal regimen for antibiotic prophylaxis in caesarean section by comparing single versus multiple doses of the same intervention.
METHODS: MEDLINE, Web of Knowledge, SCOPUS, CENTRAL and ongoing trials databases were searched. Reference lists were reviewed and international groups contacted.
METHODS: Randomised controlled trials (RCT) comparing single with multiple dose regimens of the same antibiotic prophylaxis. Quasi-RCT and abstracts were suitable for inclusion.
METHODS: Reviewers independently extracted data and assessed quality of evidence. A random-effects model was used and results presented as risk ratio (RR) with 95% confidence intervals (CI).
RESULTS: Sixteen studies were included, involving 2695 women. Nonsignificant differences were observed between single dose and multiple dose antibiotic prophylaxis in the incidence of postpartum infectious morbidity (RR 0.95, 95% CI 0.75-1.20, I2 = 25%), endometritis (RR 1.03, 95% CI 0.74-1.42, I2 = 0%) and wound infection (RR 1.22, 95% CI 0.72-2.08, I2 = 0%). A trend towards lower risk of urinary tract infection was seen with multiple dose (RR 0.65, 95% CI 0.34-1.24, I2 = 0%).
CONCLUSIONS: There was insufficient evidence to determine whether there is a difference between single and multiple dose regimens in reducing the incidence of infectious morbidity after caesarean section. The quality of evidence was very low and well-designed RCTs are needed.
CONCLUSIONS: Insufficient evidence of difference between dosage regimens of antibiotic prophylaxis in caesarean section.
摘要：
背景：传统上，预防性抗生素以单剂量用于剖腹产。然而,建议的不一致应用和最近的证据促使文献综述.
目的：通过比较单剂量和多剂量相同干预措施，评估剖宫产中抗生素预防的最佳方案。
方法：MEDLINE，WebofKnowledge,Scopus,检索CENTRAL和正在进行的试验数据库。审查了参考清单，并联系了国际组织。
方法：随机对照试验（RCT）比较相同抗生素预防的单剂量和多剂量方案。准RCT和摘要适合纳入。
方法：评审员独立提取数据并评估证据质量。使用随机效应模型，并将结果表示为具有95％置信区间（CI）的风险比（RR）。
结果：纳入了16项研究，涉及2695名女性。单剂量和多剂量抗生素预防在产后感染发病率中观察到无显着差异(RR0.95,95%CI0.75-1.20,I2=25%),子宫内膜炎(RR1.03,95%CI0.74-1.42,I2=0%)和伤口感染(RR1.22,95%CI0.72-2.08,I2=0%)。多剂量组出现尿路感染风险降低的趋势(RR0.65,95%CI0.34-1.24,I2=0%)。
结论：没有足够的证据来确定单剂量和多剂量方案在降低剖宫产后感染发病率方面是否存在差异。证据质量非常低，需要精心设计的随机对照试验。
结论：没有足够的证据表明剖宫产术中抗生素预防给药方案之间存在差异。
目的：通过比较单剂量和多剂量相同干预措施，评估剖宫产中抗生素预防的最佳方案。
方法：MEDLINE，WebofKnowledge,Scopus,检索CENTRAL和正在进行的试验数据库。审查了参考清单，并联系了国际组织。
方法：随机对照试验（RCT）比较相同抗生素预防的单剂量和多剂量方案。准RCT和摘要适合纳入。
方法：评审员独立提取数据并评估证据质量。使用随机效应模型，并将结果表示为具有95％置信区间（CI）的风险比（RR）。
结果：纳入了16项研究，涉及2695名女性。单剂量和多剂量抗生素预防在产后感染发病率中观察到无显着差异(RR0.95,95%CI0.75-1.20,I2=25%),子宫内膜炎(RR1.03,95%CI0.74-1.42,I2=0%)和伤口感染(RR1.22,95%CI0.72-2.08,I2=0%)。多剂量组出现尿路感染风险降低的趋势(RR0.65,95%CI0.34-1.24,I2=0%)。
结论：没有足够的证据来确定单剂量和多剂量方案在降低剖宫产后感染发病率方面是否存在差异。证据质量非常低，需要精心设计的随机对照试验。
结论：没有足够的证据表明剖宫产术中抗生素预防给药方案之间存在差异。
