Scolaris Content Display Scolaris Content Display

Flow diagram.
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Figure 1

Flow diagram.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 3

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Comparison 1 Short‐term versus long‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.
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Analysis 1.1

Comparison 1 Short‐term versus long‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.

Comparison 2 Sensitivity analysis: short‐term versus long‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.
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Analysis 2.1

Comparison 2 Sensitivity analysis: short‐term versus long‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.

Comparison 3 Preoperative versus short‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.
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Analysis 3.1

Comparison 3 Preoperative versus short‐term antibiotic prophylaxis, Outcome 1 Surgical site infection.

Comparison 3 Preoperative versus short‐term antibiotic prophylaxis, Outcome 2 Adverse events.
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Analysis 3.2

Comparison 3 Preoperative versus short‐term antibiotic prophylaxis, Outcome 2 Adverse events.

Comparison 4 Amoxicillin versus ampicillin, Outcome 1 Surgical site infection.
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Analysis 4.1

Comparison 4 Amoxicillin versus ampicillin, Outcome 1 Surgical site infection.

Comparison 4 Amoxicillin versus ampicillin, Outcome 2 Adverse events.
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Analysis 4.2

Comparison 4 Amoxicillin versus ampicillin, Outcome 2 Adverse events.

Comparison 5 Amoxicillin and clavulanic acid versus cefuroxime, Outcome 1 Surgical site infection.
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Analysis 5.1

Comparison 5 Amoxicillin and clavulanic acid versus cefuroxime, Outcome 1 Surgical site infection.

Short‐term antibiotic prophylaxis compared with long‐term antibiotic prophylaxis in patients undergoing orthognathic surgery

Patient or population: patients undergoing orthognathic surgery

Intervention: short‐term antibiotic prophylaxis

Comparison: long‐term antibiotic prophylaxis

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Short‐term

Long‐term

Surgical site infection

Follow‐up: 2 to 36 weeks

168 per 1000a

71 per 1000

(41 to 125)

RR 0.42 (0.24 to 0.74)

472
(7 studies)

⊕⊕⊕⊝
moderateb

This outcome was measured using different definitions. We accepted all authors' definitions

Systemic infection

Not reported

This outcome was not reported in any of the trials

Adverse events

Not reported

This outcome was not reported in any of the trials

Duration of hospital stay

Not reported

This outcome was not reported in any of the trials

Health‐related quality of life

Not reported

This outcome was not reported in any of the trials

*The basis for the assumed risk (e.g. mean control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio.

GRADE Working Group grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

aAssumed risk based on control arms of included trials.
bMost of these trials were judged to have unclear risk of bias in the domains of allocation concealment and blinding.

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Preoperative antibiotic prophylaxis compared with short‐term antibiotic prophylaxis in patients undergoing orthognathic surgery

Patient or population: patients undergoing orthognathic surgery

Intervention: preoperative antibiotic prophylaxis

Comparison: short‐term antibiotic prophylaxis

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No. of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Preoperative

Short‐term

Surgical site infection

Follow‐up: 4 to 12 weeks

82 per 1000a

28 per 1000
(8 to 101)

RR 0.34 (0.09 to 1.22)

220
(2 studies)

⊕⊕⊝⊝
lowb,c

This outcome was measured using different definitions. We accepted all authors' definitions

Adverse events

Follow‐up: up to 12 weeks

0 per 35

See comment

0 per 35

See comment

Not estimable

70
(1 study)

⊕⊕⊝⊝
lowd,e

No adverse events were reported in any of arms of the trial

Systemic infection

Not reported

This outcome was not reported in any of the trials

Duration of hospital stay

Not reported

This outcome was not reported in any of the trials

Health‐related quality of life

Not reported

This outcome was not reported in any of the trials

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk Ratio

GRADE Working Group grades of evidence.
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

aAssumed risk based on control arms of included trials.
bMost of the trials were judged to have unclear risk of bias in the domains of allocation concealment and blinding.
cThe 95% CI of the pooled estimate suggests both benefit and harm.
dThe trial was judged to have unclear risk of bias in the domains of allocation concealment and blinding.
eThe number of participants included in this analysis is below the optimal information size.

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Comparison 1. Short‐term versus long‐term antibiotic prophylaxis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

7

472

Risk Ratio (IV, Random, 95% CI)

0.42 [0.24, 0.74]

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Comparison 1. Short‐term versus long‐term antibiotic prophylaxis
Comparison 2. Sensitivity analysis: short‐term versus long‐term antibiotic prophylaxis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

6

438

Risk Ratio (IV, Random, 95% CI)

0.41 [0.22, 0.75]

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Comparison 2. Sensitivity analysis: short‐term versus long‐term antibiotic prophylaxis
Comparison 3. Preoperative versus short‐term antibiotic prophylaxis

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

2

220

Risk Ratio (IV, Fixed, 95% CI)

0.34 [0.09, 1.22]

2 Adverse events Show forest plot

1

70

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

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Comparison 3. Preoperative versus short‐term antibiotic prophylaxis
Comparison 4. Amoxicillin versus ampicillin

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

1

Risk Difference (IV, Random, 95% CI)

Totals not selected

2 Adverse events Show forest plot

1

42

Risk Ratio (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

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Comparison 4. Amoxicillin versus ampicillin
Comparison 5. Amoxicillin and clavulanic acid versus cefuroxime

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Surgical site infection Show forest plot

1

Risk Ratio (IV, Fixed, 95% CI)

Totals not selected

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Comparison 5. Amoxicillin and clavulanic acid versus cefuroxime