Clinical Efficacy and Safety of Ceftriaxone in Surgical Prophylaxis: A Systematic Review and Meta-Analysis

Abstract:

Introduction: Adequate antimicrobial monitoring helps identify the changing pattern of infection prevention postoperatively. The review aims at assessing the efficacy and safety of prophylactic ceftriaxone in surgical site infection. Materials and Methods: The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A systematic search was conducted in PubMed, EMBASE, and CINAHL databases. Randomized control trials, published till December 2022 in English, studying only preoperative ceftriaxone, and focusing on general surgical procedures were included. Meta-analysis was done using review manager software. Results: Of the 2961 articles, nine were included in the review. Elevated gram-positive (33%) and gram-negative (67%) isolates were observed from the surgical site post-prophylaxis. Surgical site infection was developed in 53 (3.41%) patients in the ceftriaxone group and 108 (6.9%) patients in the comparator groups [OR 0.47 (95% CI: 0.33-0.65), p<0.0001]. Adverse events were assessed in six studies, from which 111 (21.4%) and 163 (31.2%) patients in the intervention and comparator groups developed the same [RR: 0.56 (95% CI: 0.31-1.01), p=0.06]. An overall estimate of [MD: -1.12 (95%CI: -1.36 to -0.89), p<0.00001)] was obtained on assessing hospital stays in the included articles. Conclusion: The evidence generated identified various microbial isolates from the infected sites. The drug assured its efficacy profile in surgical prophylaxis. More studies in general surgery can give a better conclusion about ceftriaxone prophylaxis.

 Keywords: Ceftriaxone, Prophylaxis, Surgical Site Infection