1. PROSPERO International prospective register of systematic reviews
Antibiotic prophylaxis for preventing postoperative infection in women undergoing
abdominal hysterectomy
Ashraf Nabhan, Noha Usama, Raghda Rashad, Ahmed K. Aly, Shaimaa Fattin, Reham Ahmed, Nesma Abdelhady, Ahmed Mostafa,
Essam Hashim
Citation
Ashraf Nabhan, Noha Usama, Raghda Rashad, Ahmed K. Aly, Shaimaa Fattin, Reham Ahmed, Nesma Abdelhady,
Ahmed Mostafa, Essam Hashim. Antibiotic prophylaxis for preventing postoperative infection in women undergoing
abdominal hysterectomy. PROSPERO 2012:CRD42012002407 Available from
http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42012002407
Review question(s)
To compare antibiotic prophylaxis with placebo for preventing postoperative infection in women undergoing
abdominal hysterectomy.
Searches
Electronic searches: We will search the Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE
(January 1966 to May 2012).
Searching other resources: We will search RCT trial registers for ongoing or unpublished trials. We will hand search
the citation lists of relevant publications, review articles, and included studies.
We will not apply any language restrictions.
Types of study to be included
Randomized controlled trials comparing antibiotic prophylaxis versus a placebo whether parallel or multiple arms
(other arms with different class, route, dosage). Quasi-randomised trials will not be included.
Condition or domain being studied
The most commonly performed major gynecologic surgery is hysterectomy, whether total or subtotal. The procedure
is classified into abdominal, vaginal, and various laparoscopic methods. The preferred method depends on the
surgeon’s expertise, the indication for surgery, the nature of the disease, patient preferences and cost. In lower and
middle income countries with limited resources, abdominal hysterectomy remains the most frequently performed.
Postoperative infection is an important outcome in women undergoing abdominal hysterectomy and its prevention
remains a challenging issue.
Participants/ population
women undergoing abdominal hysterectomy whether total or subtotal.
Exclusion criteria:
1. radical abdominal hysterectomy.
2. abdominal hysterectomy performed as part of cytoreductive (debulking) surgery.
Intervention(s), exposure(s)
Antibiotic prophylaxis (all classes, all dosages, all routes).
Comparator(s)/ control
Placebo.
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2. Context
In-patient
Outcome(s)
Primary outcomes
1. Postoperative infection (composite outcome including surgical site infection plus pelvic infection).
2. Surgical site infection.
3. Pelvic infection (including vaginal cuff infection, pelvic abscess).
Eight weeks post operative.
Secondary outcomes
1. Length of hospital stay.
2. Need for secondary suture.
3. Hospital readmission.
Data extraction, (selection and coding)
Three investigators will independently review all titles or titles and abstracts from the search results to identify
articles for full-text review. If any reviewer identifies a study as potentially eligible, the full-text will be retrieved for
further assessment.
Disagreement will be resolved by review team discussion. If any of the eligibility criteria are not met, the article will
be excluded.
Data extraction will be carried out independently and in duplicate by the study investigators in Review manager.
Results of data extraction will then be compared and any discrepancies will be resolved by discussion. If results are
incomplete or unclear, the study authors will be contacted. Relevant information will be collected on study
characteristics, baseline patient characteristics, interventions, and outcomes.
Risk of bias (quality) assessment
We will use the risk of bias tool of the Review manager 5.
Strategy for data synthesis
We will carry out statistical analysis using the Review Manager software. The data to be used will be aggregate.
For dichotomous data, we will present results as summary relative risk (RR) with 95% confidence intervals (CI). For
continuous data, we will use the mean difference and 95% CI. Assessment of heterogeneity will be calculated using
the chi-squared test as well as I-squared. In case of substantial heterogeneity (>50%), we will use a random effects
model.
Analysis of subgroups or subsets
1. Total versus subtotal hysterectomy.
2. Post versus pre menopausal women.
3. Dosage: single versus multiple.
4. Route: IV versus IM versus rectal.
Dissemination plans
The review will be disseminated to policy maker in Egypt, particularly in University and Teaching hospitals though
electronic media. We plan to publish the review in a peer-reviewed journal
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3. Contact details for further information
Ashraf Nabhan
Department of Obstetrics and Gynecology, Ain Shams University, Abbassia, Cairo, Egypt
ashraf.nabhan@gmail.com
Organisational affiliation of the review
Health Research Unit, Department of Obstetrics and Gynecology, Ain Shams University
http://healthru.wordpress.com
Review team
Professor Ashraf Nabhan, Ain Shams University
Dr Noha Usama, Ain Shams University
Dr Raghda Rashad, Ain Shams University
Dr Ahmed K. Aly, Ain Shams University
Dr Shaimaa Fattin, Ain Shams University
Dr Reham Ahmed, Ain Shams University
Dr Nesma Abdelhady, Ain Shams University
Dr Ahmed Mostafa, Ain Shams University
Dr Essam Hashim, Ain Shams University
Anticipated or actual start date
01 January 2012
Anticipated completion date
01 August 2013
Funding sources/sponsors
None
Conflicts of interest
None known
Language
English
Country
Egypt
Subject index terms status
Subject indexing assigned by CRD
Subject index terms
Antibiotic Prophylaxis; Humans; Hysterectomy; Surgical Wound Infection
Stage of review
Completed but not published
Date of registration in PROSPERO
18 May 2012
Date of publication of this revision
13 October 2014
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4. Stage of review at time of this submission Started Completed
Preliminary searches Yes Yes
Piloting of the study selection process Yes Yes
Formal screening of search results against eligibility criteria Yes Yes
Data extraction Yes Yes
Risk of bias (quality) assessment Yes Yes
Data analysis Yes Yes
PROSPERO
International prospective register of systematic reviews
The information in this record has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record,
any associated files or external websites.
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