Clinical practice guidelines for surgical antimicrobial prophylaxis: Qualitative appraisals and synthesis of recommendations

Autor(es)

Wainberg, Sheila Kalb ^[1] ; Leite Santos, Nathalia Celini ^[1] ; Gabriel, Franciele Cordeiro ^[1] ; de Vasconcelos, Luciana Pereira ^[1] ; Nascimento, Jessica Santos ^[2] ; Rezende Costa Molino, Caroline de Godoi ^[1] ; de Melo, Daniela Oliveira ^[3]

Afiliação do(s) autor(es)

^[1] Univ Sao Paulo, Fac Pharmaceut Sci, Dept Pharm, Sao Paulo - Brazil

^[2] Univ Fed Sao Paulo, Multiprofess Residency Program Orthoped & Traumat, Sao Paulo - Brazil

^[3] Univ Fed Sao Paulo, Dept Pharmaceut Sci, Inst Environm Sci Chem & Pharmaceut, Sao Paulo - Brazil

• Tipo de documento: Artigo de Revisão
• Fonte: JOURNAL OF EVALUATION IN CLINICAL PRACTICE; v. 25, n. 4, p. 591-602, AUG 2019.
• Citações Web of Science: 3

Resumo

Rationale, goals, and objectives Clinical practice guidelines (CPGs) for preoperative care have been developed for surgical antimicrobial prophylaxis (SAP). The objective of this study was to synthetize recommendations for SAP based on best-evaluated CPGs. Methods A systematic literature search for documents related to SAP, published between January 2011 and December 2016, was conducted on MEDLINE (PubMed), EMBASE, and specific CPG websites. Three reviewers independently assessed the rigour of development and editorial independence of CPGs based on domains 3 and 6 of the Appraisal of Guidelines for Research \& Evaluation II (AGREE II) instrument. CPGs with domain 3 scores of 50% and greater were selected for synthesis of recommendations. Two reviewers independently extracted CPG recommendations from among these documents. A third reviewer performed the synthesis of recommendations. Results The search retrieved 363 documents, of which 29 CPGs were appraised using AGREE II. Only eight (28%) scored 50% and greater in domain 3. Most CPGs addressed topics related to preoperative care, including SAP. No conflicting recommendations were found, and most recommendations were based on clinical practice. The only recommendation for which there was a difference among CPGs was with respect to the time to initiate the administration of antibiotics (1 hour before or close to the time of the surgical incision). Four CPGs provide recommendations that demonstrate concern about inadequate SAP prolongation. Conclusion Several CPGs for SAP were developed without the desired methodological rigour or transparency. Synthesis of recommendations for best-evaluated CPGs provides a broad approach owing to the complementarity of the recommendations. (AU)

• Processo FAPESP: 16/13700-9 - Competições terapêuticas em idosos da comunidade com multimorbidades (saúde, bem-estar e envelhecimento - Estudo SABE)
• Beneficiário: Caroline de Godoi Rezende Costa Molino
• Modalidade de apoio: Bolsas no Brasil - Doutorado