Antimicrobials as an adjunct to pilonidal disease surgery: a systematic review of the literature

Surgical site infection (SSI) after pilonidal disease surgery can lead to serious complications. We systematically searched the PubMed, Scopus, and ClinicalTrials.gov databases for studies evaluating the use of antimicrobials as an adjunct to pilonidal disease surgery. We identified 12 eligible stud...

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Bibliographic Details
Published in:European journal of clinical microbiology & infectious diseases 2013-07, Vol.32 (7), p.851-858
Main Authors: Mavros, M. N., Mitsikostas, P. K., Alexiou, V. G., Peppas, G., Falagas, M. E.
Format: Article
Language:English
Subjects:
Abscesses
Anti-Infective Agents - therapeutic use
Antibiotic Prophylaxis - methods
Antibiotics
Antimicrobial agents
Biological and medical sciences
Biomedical and Life Sciences
Biomedicine
Clinical trials
Cohort analysis
Comparative studies
Disease prevention
Heterogeneity
Humans
Infectious diseases
Internal Medicine
Literature reviews
Medical Microbiology
Medical sciences
Prophylaxis
Review
Sinuses
Skin Diseases, Bacterial - drug therapy
Skin Diseases, Bacterial - surgery
Surgeons
Surgical Procedures, Operative - methods
Surgical site infections
Surgical techniques
Surgical Wound Infection - prevention & control
Systematic review
Treatment Outcome
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Summary:Surgical site infection (SSI) after pilonidal disease surgery can lead to serious complications. We systematically searched the PubMed, Scopus, and ClinicalTrials.gov databases for studies evaluating the use of antimicrobials as an adjunct to pilonidal disease surgery. We identified 12 eligible studies [nine randomized controlled trials (RCTs), three retrospective cohort studies], enrolling a total of 1,172 patients. No difference was observed when single-dose prophylaxis was compared to no prophylaxis or to a long course of antibiotics (seven studies, 690 patients). Similarly, gentamicin collagen sponges (GCS) did not appear to be beneficial when compared with no GCS (with primary or secondary closure; four studies, 402 patients). One study (80 patients) reported faster healing and lower SSI and recurrence rates with GCS than a 7-day course of antibiotics. The clinical heterogeneity precluded a formal meta-analysis. Although the generalization of our findings may be limited by the relative paucity and clinical heterogeneity of the existing studies, prophylactic antibiotics or GCS did not appear to be beneficial in promoting healing or reducing SSI or recurrence rates. Large, double-blind, placebo-controlled RCTs are warranted in order to further elucidate this issue.
ISSN:0934-9723
1435-4373
DOI:10.1007/s10096-013-1830-z