β-Lactam vs Non–β-Lactam Prophylaxis in Elective Colorectal Surgery
Main finding · 30-day SSIResult — go to the resultAdjusted relative risk 0.74 95% CI 0.63–0.87Authors' conclusion
In this cohort study of elective colorectal surgery procedures, β-lactam surgical prophylaxis was associated with significantly lower SSI risk compared with non-β-lactam alternatives. Differences in guideline-concordant dosing and timing between cohorts were not associated with SSI risk in adjusted analyses.
Study context
- Population
- Adults (>18 years) undergoing elective colorectal surgery, July 2012–June 2021
- Participants
- 20,140 procedures
- Exposure
- β-Lactam vs non-β-lactam alternative surgical prophylaxis
- β-lactamn = 18,098
- Non-β-lactam alternativen = 2,042reference
- Outcome
- SSI
- Follow-up
- 30-day
Methodological detailsmulticentre, regional data registry, propensity score matching sensitivity analysis
- Multicentre
- Regional data registry
- Propensity score matching sensitivity analysis
Main finding
30-day SSI
Adjusted relative risk
0.74
95% CI 0.63–0.87
P < 0.001
Events by group
β-lactam vs non-β-lactam alternative
ARR 0.74 (95% CI 0.63–0.87); P < 0.001
As reported in the abstract
Observational data: associations, not effects.
Further findings
Guideline-concordant dosing
P < 0.001
Guideline-concordant timing
P < 0.001
Combined guideline-concordant dose and timing
P < 0.001
SSI risk by guideline-concordant dosing and timing
| ARR (95% CI) | P value | ||
|---|---|---|---|
| Guideline-concordant dosing | 1.04 (0.91–1.20) | P = 0.54 | |
| Guideline-concordant timing | 1.13 (0.92–1.38) | P = 0.25 | |
| 0.512Adjusted relative risk (log scale) |
Original publication
β-Lactam vs Non–β-Lactam Prophylaxis in Elective Colorectal Surgery. JAMA Netw Open. Published 1 April 2026. doi:10.
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