β-Lactam vs Non–β-Lactam Antimicrobial Prophylaxis and Surgical Site Infection
Main finding · SSIResult — go to the resultAdjusted odds ratio 1.78 95% CI 1.59–1.99Authors' conclusion
In this large cohort study, administration of non-β-lactam SAP was associated with 1.8-fold higher odds of SSI.
Study context
- Population
- Adults undergoing major surgery with surgical antimicrobial prophylaxis (SAP) within 120 minutes before incision and postdischarge follow-up, Swissnoso surgical site infection (SSI) surveillance (175 hospitals), 2009–2020; wound contamination class IV excludedof 538,976 surveilled
- Participants
- 348,885 adults
- Exposure
- Non-β-lactam vs β-lactam surgical antimicrobial prophylaxis
- β-Lactam SAPn = 342,936reference
- Non-β-lactam SAPn = 5,949
- Outcome
- Occurrence of SSI, according to Centers for Disease Control and Prevention definitions
Methodological detailsmulticentre surveillance system, mixed-effects logistic regression adjusted for confounders
- Multicentre surveillance system
- Mixed-effects logistic regression adjusted for confounders
Main finding
SSI
Adjusted odds ratio
1.78
95% CI 1.59–1.99
P < 0.001
Events by group
Non-β-lactam SAP vs β-Lactam SAP
aOR 1.78 (95% CI 1.59–1.99); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
| Outcome | aOR (95% CI) | P value | |
|---|---|---|---|
| SSI by agentCiprofloxacin vs β-Lactam SAP | 1.57 (1.33–1.87) | P < 0.001 | |
| SSI by agentVancomycin vs β-Lactam SAP | 1.38 (1.03–1.86) | P = 0.04 | |
| SSI by agentClindamycin vs β-Lactam SAP | 2.12 (1.82–2.47) | P < 0.001 | |
| 0.512Adjusted odds ratio (log scale) |
SSI by procedure type (subgroup)
- Higher SSI rate for non-β-lactam SAP across all procedure types
Original publication
β-Lactam vs Non–β-Lactam Antimicrobial Prophylaxis and Surgical Site Infection. JAMA Netw Open. Published 1 October 2025. doi:10.
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