Abstract
BackgroundThis existing literature on the link between surgical site infection and beta-lactam allergy displays varying results. This systematic review and meta-analysis seek to consolidate the existing evidence and assess the potential correlation between beta-lactam allergy and surgical site infection. MethodsOnline databases including PubMed, Scopus, and Web of Science were searched by systematic search until January 2024. Keywords and mesh terms related to surgical site infection, beta-lactam or penicillin allergy were used. A random-effects model was employed for the meta-analysis, and subgroup analyses were conducted to investigate heterogeneity. Funnel plots and statistical tests were utilized to evaluate publication bias. ResultsAmong 26 studies included in the systematic review, 22 studies were eligible for the analysis. The result of their data analysis shows the relationship between beta-lactam allergy and surgical site infection. The meta-analysis revealed a significant effect, with a pooled OR of 1.83 (95% CI: 1.46-2.30). In the analysis, 13 odds ratios (ORs) were reported specifically for penicillin allergy, a subset of beta-lactams, resulting in a pooled OR of 1.68 (95% CI: 1.35-2.09, I²=64.2%) (Figure 3). Conversely, the other nine studies, which did not differentiate a specific drug within the beta-lactam category, showed an OR of 1.88 (95% CI: 1.31-2.77). Subgroup analysis was performed based on the type of surgery and the results were as follows: orthopedic (1.65, CI= 1.12-2.44), dental (3.14, CI= 1.41-6.96), combined general surgeries (1.98, CI= 1.04-3.75), neurosurgical (1.78, CI=0.96-3.28), transplant (0.69, CI=0.34-1.42), cesarean (2.13, CI=1.56-2.91), and gastrointestinal (1.86, CI= 0.62-5.57) ConclusionAccording to the results, this study shows that there is a significant and clear relationship between having a surgical site infection in different surgeries and having an allergy to beta-lactam antibiotics. It is suggested that more studies be conducted with a suitable population in all types of surgery in people with allergies to beta-lactam antibiotics so that a more suitable treatment for surgical site infection can be carried out.
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