Wounds: simple: prophylactic antibiotics do not prevent wound infections

Clinical bottom line (level 1a)

  1. Patients with uninfected simple wounds who receive prophylactic systemic antibiotics are no less likely to develop a wound infection than those given nothing.
Cummings and Del Beccaro: American Journal of Emergency Medicine 1995; 13: 396-400
Expires October 2004

The study

Systematic review of all randomised controlled trials of
  • Patients: non-bite wounds
  • Intervention: prophylactic systemic antibiotics compared with no antibiotics
  • Outcome: wound infection


    • Articles found in all languages using MEDLINE, 1966 to 1993 (search terms: 'wound infection' and 'antibiotics' ) and searching bibliographies of clinical trials and reviews

    Selection criteria: see above
    Appraisal criteria: by blinded review: criteria used not given
    Articles excluded if:
    • not intention-to-treat


    7 randomised controlled trials found, involving 1734 patients receiving penicillins or cephalosporins.
    One study appeared anomalous (112 patients) but exclusion did not affect the analysis.

    The evidence

    Outcome Time to outcome CER OR
    (95% CI)    		 NNH
    (95% CI)
    wound infection unknown 46/762
    (6.0%)    		 1.16
    (0.77 to 1.78)     		110
    (NNT = 76 to infinity;
    NNH = 24 to infinity)

    Citation

    1. Cummings P, and Del Beccaro M: antibiotics to prevent infection of simple wounds: a meta-analysis of randomized studies. American Journal of Emergency Medicine 1995; 13: 396-400
    Contributor: Chris Ball & Bob Phillips, October 1999
    Reviewer:

    Clinical Question.
    Patient nonbite, simple wound
    Intervention or Exposure prophylactic antibiotics
    Outcome wound infection