Do Perioperative Antibiotics Improve Outcomes After Hypospadias Repair? A Systematic Review and Meta-Analysis of Pediatric Literature
Abstract
Background/Objectives: The role, timing, and duration of antibiotic therapy in hypospadias repair remain controversial, with substantial variability in clinical practice and a lack of evidence-based guidelines. This systematic review and meta-analysis aimed to evaluate whether preoperative, postoperative, or combined perioperative antibiotic regimens influence postoperative outcomes after hypospadias repair. Methods: A systematic literature search of PubMed, MEDLINE, Scopus, Embase, and Web of Science was conducted in accordance with PRISMA guidelines to identify studies published between 2000 and 2025 that reported on perioperative antibiotic administration in pediatric patients undergoing hypospadias surgery. Three comparisons were assessed: (i) postoperative antibiotics versus no antibiotics, (ii) preoperative antibiotics versus no antibiotics, and (iii) combined pre- and postoperative antibiotics versus no antibiotics. Outcomes included infectious complications, wound dehiscence, urethrocutaneous fistula, meatal or urethral stenosis, and other postoperative complications. Random-effects meta-analyses were performed, with pooled odds ratios reported together with 95% confidence intervals. Results: Ten studies comprising a total of 9493 patients were included. Perioperative antibiotic use was not associated with a significant reduction in infectious complications (OR 0.95, 95% CI 0.63-1.44; p = 0.81), urethrocutaneous fistula (OR 1.89, 95% CI 0.87-4.12; p = 0.10), or wound…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 9,493 participants or records.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.