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analyses. Second, we were unable to obtain information on the actual study years for several studies. Thus, we had to use pub- lication years to examine temporal trends. Third, except for col- orectal surgery, the analyses of the 3 other procedures had small numbers of RCTs and were potentially underpowered. In conclusion, our analysis indicates that the efficacy of cur-
rently recommended prophylactic antibiotics has declined for colorectal surgery. We did not find a declining trend for simple appendectomy, cesarean section, and TRPB. However, the small number of RCTs and low infection rates for these procedures might have decreased the statistical power. Future studies asses- sing the efficacy of surgical prophylaxis could include non-RCTs for these 3 procedures. New studies are needed to determine how antibiotic prophylaxis recommendations should be modified in the context of declining efficacy for colorectal surgery.
Acknowledgments.
Financial support. This work was supported by the Innovative Medicines Initiative Joint Undertaking (grant no. 115618) with in-kind financial contributions from the European Union’s Seventh Framework Programme and European Federation of Pharmaceutical Industries and Associations companies. The funders had no role in the study design; the collection, analysis, and interpretation of the data; the writing of the report; or the decision to submit the article for publication.
Conflicts of interest. All authors report no conflicts of interest relevant to this article.
Supplementary material. To view supplementary material for this article, please visit
https://doi.org/10.1017/ice.2018.295
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