ANTIBIOTICS TO PREVENT INFECTION OF SIMPLE WOUNDS - A METAANALYSIS OFRANDOMIZED STUDIES

A meta-analysis was conducted to determine whether prophylactic system ic antibiotics prevent infection in patients with nonbite wounds that are managed in the emergency department (ED). A literature search was performed to identify published, randomized trials of prophylactic ant ibiotics for nonbite wounds. Blinded review of trial methods was used to select trials that randomly assigned patients to antibiotic or cont rol groups and analyzed results by intention to treat. Of 9 randomized trials, 7 (with 1,734 study subjects) were accepted for analysis. The odds ratio for infection in treated patients compared with controls w as used as the measure of effect, and a summary odds ratio was calcula ted. Patients treated with antibiotics had a slightly greater incidenc e of infection compared with untreated controls: odds ratio 1.16 (95% confidence interval [CI] 0.77 to 1.78). Even among patients treated wi th a penicillinase-resistant antibiotic (5 trials with 1,204 patients) , there was no benefit from treatment; odds ratio 1.00 (95% CI 0.59 to 1.71). In conclusion, there is no evidence in published trials that p rophylactic antibiotics offer protection against infection of nonbite wounds in patients treated in EDs. (C) 1995 by W.B. Saunders Company