Efficacy of postoperative antibiotic use after tibial plateau leveling osteotomy in dogs: A systematic review

被引:17
作者
Budsberg, Steven C. [1 ,2 ]
Torres, Bryan T. [3 ]
Sandberg, Gabriella S. [1 ]
机构
[1] Univ Georgia, Dept Small Anim Med & Surg, Athens, GA 30602 USA
[2] Univ Georgia, Dept Comparat Physiol & Pharmacol, Athens, GA 30602 USA
[3] Univ Missouri, Dept Vet Med & Surg, Columbia, MO USA
关键词
SURGICAL SITE INFECTION; HETEROGENEOUS POPULATION; TUBEROSITY ADVANCEMENT; EXTRACAPSULAR REPAIR; COMPLICATIONS; TPLO; METAANALYSES; INFLAMMATION; RUPTURE; SURGERY;
D O I
10.1111/vsu.13603
中图分类号
S85 [动物医学(兽医学)];
学科分类号
0906 ;
摘要
Objective A systematic review of published data to determine whether postoperative antibiotic use after tibial plateau leveling osteotomy (TPLO) decreases infection rates. Study design Systematic review. Methods A broad bibliographic search was performed in three online databases through March 2020 for publications on postoperative antibiotic use after TPLO in dogs. Search terms included dog, canine, TPLO, tibial plateau leveling osteotomy, infection, antibiotic, and antimicrobial. Articles that met inclusion criteria were evaluated for level of evidence (LoE) by a modified Oxford Level of Evidence (mOLE) and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) classification and evaluation. Results Thirteen studies met the inclusion criteria. Effect of antibiotic use was the primary question in four studies. Among those, 50% (2/4) were assigned a mOLE of 1b and a GRADE of moderate, while the other 50% (2/4) were assigned a mOLE of 4b or 4c with a GRADE of low. The two studies with the highest LoE did not provide evidence of the benefit of antibiotic usage. Results of only one study provided evidence to support the use of postoperative antibiotics. The remaining nine studies provided evaluation of antibiotic use secondarily and were all assigned a low LoE. Among these, 78% (7/9) provided evidence to support the use of postoperative antibiotics. Conclusion We found little evidence to support the use of postoperative antibiotics to reduce the risk of surgical site infections in dogs after TPLO. The answer to this clinical question is complicated by the lack of prospective studies and inconsistent treatment protocols in the evaluated studies. Clinical significance The clinical impact of postoperative antibiotic administration on infection rates after TPLO is uncertain.
引用
收藏
页码:729 / 739
页数:11
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