Prophylactic Antibiotics in Arteriovenous Fistulae: A systematic Review

Abstract

Background: The aim of this study is to establish and evaluate whether the use of prophylactic antibiotics in the creation of any autogenous arteriovenous fistula in hemodialysis patients is indicated, evidence-based and/or recommended. Methods: A systematic review and meta-aggregation of the literature from 1966 to August 2016 in the English language in Medline, Scopus, Embase and Cochrane Library was conducted. Results: The search produced a total of n=94 articles. Following the application of the recruitment criteria in accordance to PRISMA one (n=1) article was found eligible with a population of n=611 patients undergoing autogenous fistula formation. A total of n=136 patients received prophylactic antibiotics with no incidence of surgical site infection (SSI). The reported incidence of SSI in the group of patients (n=475) that did not receive prophylactic antibiotics was 0.2% (n=1). The quality of the article was assessed by the Oxford Critical Appraisal Skills Programme (CASP) and their recommendation for practice was evaluated through National Institute for Health and Care Excellence (NICE). Conclusion: The first systematic review of the literature demonstrates that the current use of prophylactic antibiotics in the creation of any autogenous AVF is not evidence-based and further research in this area is highly advocated.