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    When should old therapies be abandoned? A modern look at old studies on topical ampicillin.

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    Authors
    Charalambous, C
    Tryfonidis, Marios
    Swindell, Ric
    Lipsett, A Pamela
    Affiliation
    Department of Surgery, Manchester Royal Infirmary, Manchester, M13 9WL, UK.
    Issue Date
    2003-10
    
    Metadata
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    Abstract
    OBJECTIVE: We sought to determine whether topical ampicillin can reduce the rate of wound infections in clean contaminated surgical wounds (appendectomy, colorectal surgery). METHOD: All randomized controlled trials examining the use of topical ampicillin in appendectomy and colorectal surgery published in English were identified via a Medline, Advanced Medline, and Cochraine Controlled Trials Register search and a meta-analysis performed.Results. Topical ampicillin vs. no antibiotic prophylaxis in clean contaminated wounds significantly reduced surgical wound infection rates (Odds Ratio (OR)=0.084, 95% CI, 0.04-0.16, P<0.0001). Topical ampicillin vs. no antibiotic prophylaxis in contaminated wounds also reduced surgical wound infection (OR=0.262, 95% CI, 0.14-0.51, P<0.0001). Topical ampicillin combined with systemic antibiotics vs. systemic antibiotics alone did not reduce surgical wound infection rate (OR=0.927, 95% CI, 0.27-1.72, P=0.90). CONCLUSION: Topical ampicillin significantly reduces the rate of surgical wound infections in clean contaminated surgery. A significant but smaller effect is seen in appendectomies where the appendix is gangrenous or perforated. Topical ampicillin did not confer any additional benefit when systemic antibiotics are used. While ampicillin may no longer be an effective agent, topical application of antibiotics is effective.Summary. A meta-analysis of studies using topical ampicillin for the prevention of infection in clean contaminated wound suggests that topical ampicillin is effective, but no incremental benefit is seen with systemic antibiotics.
    Citation
    When should old therapies be abandoned? A modern look at old studies on topical ampicillin. 2003, 47 (3):203-9 J. Infect.
    Journal
    The Journal of Infection
    URI
    http://hdl.handle.net/10541/79075
    DOI
    10.1016/S0163-4453(03)00071-9
    PubMed ID
    12963381
    Type
    Article
    Language
    en
    ISSN
    0163-4453
    ae974a485f413a2113503eed53cd6c53
    10.1016/S0163-4453(03)00071-9
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