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Prophylactic Antibiotics for Mesh Inguinal Hernioplasty: A Meta-analysis

Sanabria, Alvaro MD, MSc; Domínguez, Luis Carlos MD, MSc; Valdivieso, Eduardo MD, MSc; Gómez, Gabriel MD, MPH

doi: 10.1097/01.sla.0000250412.08210.8e

Objective: To assess the effectiveness of antibiotic prophylaxis in mesh hernioplasty.

Background: Antibiotic prophylaxis use in mesh inguinal hernioplasty is controversial. Available evidence is nonconclusive because of the low number of clinical trials assessing its effectiveness. Some trials have a small sample size that could overestimate or underestimate the real effectiveness of this intervention. Meta-analysis is a good method to improve these methodological flaws.

Methods: Meta-analysis intended to measure the benefits of antibiotic prophylaxis on surgical site infection rate in adult patients scheduled for mesh inguinal hernioplasty. Six randomized clinical trials were found. Quality was assessed using Cochrane Collaboration criteria.

Results: A total of 2507 patients were analyzed. Surgical site infection frequency was 1.38% in the antibiotic group versus 2.89% in the control group (odds ratio = 0.48; 95% confidence interval, 0.27–0.85). There was no statistical heterogeneity. Sensitivity analysis by quality did not show differences in overall results.

Conclusion: Antibiotic prophylaxis use in patients submitted to mesh inguinal hernioplasty decreased the rate of surgical site infection by almost 50%.

A meta-analysis on prophylactic antibiotics in mesh hernia repair that included 6 randomized controlled trials showed that antibiotics decrease the frequency of surgical site infection by approximately 50%.

From the Grupo Colaborativo de Epidemiología Quirúrgica, Department of Surgery, School of Medicine, Pontificia Universidad Javeriana-Hospital, Universitario San Ignacio, Bogotá, Colombia.

Reprints: Alvaro Sanabria, MD, MSc, Hospital Universitario San Ignacio, Cra 7, No. 40-62 of 718, Bogotá, Colombia. E-mail:

© 2007 Lippincott Williams & Wilkins, Inc.