Comparative Effectiveness of Single-Dose vs. Multi-Dose Prophylactic Antibiotics in Reducing Post-Surgical Infections: A Systematic Review and Meta-Analysis

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Khan S.; Amro M.; Khalidi M.; Sultana S.; Pereira M.; El Said M.

Journal: International Journal of Microbiology

Publisher: John Wiley and Sons Ltd

Publication Date: 21 May 2026

Volume / Issue: Volume 2026 / Issue 1

Article No.: 8368761

ISSN: 1687918X

DOI: 10.1155/ijm/8368761

Scopus: View on Scopus

Document Type: Review

Access: All Open Access; Gold Open Access; Green Open Access

Authors and Affiliations

Khan S., General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia; Amro M., General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia; Khalidi M., Bsc in Software Engineering, College of Computer Science and Information Systems, Prince Sultan University, Riyadh, Saudi Arabia; Sultana S., General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia; Pereira M., School of Medicine, Lincoln American University, Demerara-Mahaica, Georgetown, Guyana; El Said M., General Medicine Practice Program, Batterjee Medical College, Jeddah, Saudi Arabia, Department of Microbiology and Infection Prevention & Control Unit, Theodor Bilharz Research Institute, Giza, Egypt

Abstract

Background: Surgical site infections (SSIs) are among the most frequent and costly postoperative complications, contributing to increased morbidity, extended hospitalization, and healthcare burden. Although guidelines support single-dose antibiotic prophylaxis for most surgeries, multi-dose regimens remain widely used in clinical practice, especially in high-risk procedures. This review aimed to compare the effectiveness of single-dose versus multiple-dose prophylactic antibiotic regimens in preventing postoperative infections. Methods: A systematic review and meta-analysis were conducted according to PRISMA 2020 guidelines. Databases including PubMed, Scopus, CENTRAL, Web of Science, and ScienceDirect were searched up to February 2025. Studies involving human participants undergoing surgery, comparing single- and multiple-dose antibiotic prophylaxis with infection-related outcomes, were included. Risk of bias was assessed using the Cochrane RoB 2.0 and MINORS tools. Meta-analyses were performed using random-effects models. Results: Forty-seven studies encompassing various surgical disciplines and patient populations were included. No statistically significant difference in SSI rates was observed between single- and multiple-dose groups (OR: 1.10 [95% CI: 0.87–1.39], p = 0.43). Similarly, no differences were detected for other postoperative infections, mortality, or readmissions. Heterogeneity was moderate to high across analyses. Most studies reported comparable infection outcomes despite differences in antibiotic type, follow-up duration, and surgical setting. Conclusion: Single-dose antibiotic prophylaxis is as effective as multiple-dose regimens in reducing postoperative infections in most surgical contexts. These findings support current recommendations favoring single-dose administration and reinforce antimicrobial stewardship efforts. Extended prophylaxis should be reserved for selected high-risk cases rather than routine use. Copyright © 2026 Sariya Khan et al. International Journal of Microbiology published by John Wiley & Sons Ltd.

Keywords

multiple dose; perioperative prophylaxis; prophylaxis; single dose; surgical site infections

Citation Information

Scopus Citations: 0

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