Ertapenem as an Antibiotic Prophylaxis for Colectomies and Laparotomies: A Systematic Review
Abstract
Introduction: Given concerns for antibiotic resistance, broader spectrum antibiotic agents such as ertapenem are being used for pre-operative prophylaxis. We hypothesize that pre-operative ertapenem prior to laparotomies and colectomies is superior at decreasing surgical site infections (SSIs) compared with other widely used antibiotic agents.
Methods: Medline, Embase, the Cochrane Library, and Web of Science were queried for studies until February 02, 2025. Studies were excluded if they did not evaluate ertapenem as a pre-operative antibiotic prophylaxis in patients undergoing laparotomy or colectomy, the outcome was not SSIs, or it represented a review of prior publications. Three reviewers independently extracted relevant articles, and two performed risk-of-bias analyses.
Results: Of 6,389 abstracts identified, 9 studies remained after full-text review. Seven of the included studies were observational (78%), and two (22%) were randomized controlled trials (RCTs). The median number of patients enrolled was 499 (inter-quartile range 253, 5192). Study populations included colorectal surgery (n = 8) and trauma patients undergoing laparotomy (n = 1). Ertapenem was compared with single-agent second-generation cephalosporins such as cefotetan, cefuroxime, and cefoxitin and to a single-agent penicillin with or without a combined β-lactamase inhibitor (i.e., ampicillin-sulbactam). In total, five (56%) studies showed that ertapenem was superior in preventing SSIs, decreasing SSI…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. 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: 8 participants or records.
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