6/28/23, 12:46 AM ASSIT Pathway Feedback Search Clinical Topics Home Studies ASSIT ASSIT Trial question Is extended-course antibiotic prophylaxis superior to short-course antibiotic prophylaxis in patients with lower limb amputation? Study design Single center Single blinded RCT Population Characteristics of study participants 28.0% female N = 152 72.0% male 152 patients (42 female, 110 male) Inclusion criteria: adults undergoing minor and major lower limb amputation Key exclusion criteria: known allergy to chlorhexidine/alcohol/iodophors; severe sepsis secondary to gas gangrene requiring multiple operations and admission to ICU; toe amputations Interventions N=76 extended-course antibiotic prophylaxis (5-day antibiotic course) N=76 short-course antibiotic prophylaxis (24-hour antibiotic course) Primary outcome Surgical-site infections at 30 days 39.5 39.5 % 29.6 % 19.8 % i ifi d https://web.pathway.md/studies/recqe4sLX2HH2Tqfj 1/2 6/28/23, 12:46 AM ASSIT Pathway Significant decrease 11.8 9.9 % NNT = 4 0.0 % Extended-course antibiotic prophylaxis Short-course antibiotic prophylaxis Significant decrease in surgical-site infections at 30 days (11.8% vs. 39.5%; ARD -27.7, 95% CI -44.14 to -11.26) Secondary outcomes Significant decrease in impaired wound healing (22.4% vs. 58%; RR 0.39, 95% CI 0.16 to 0.62) No significant difference in median duration of hospital stay (14 days vs. 15 days; AD -1 days, 95% CI -4.89 to 2.89) Significant decrease in the percentage of patients who had to return to the theater (6.6% vs. 21%; ARD -14.4, 95% CI -25.36 to -3.44) Safety outcomes No significant differences in death from any cause at 1 year, ICU admission, transfusion of blood products. Conclusion In adults undergoing minor and major lower limb amputation, extended-course antibiotic prophylaxis were superior to short-course antibiotic prophylaxis with respect to a surgical-site infections at 30 days. Reference Panayiotis Souroullas, Rachel Barnes, Daniel Carradice et al. Extended-course antibiotic prophylaxis in lower limb amputation: randomized clinical trial. Br J Surg. 2022 Apr 19;109(5):426- 432. Open reference URL https://web.pathway.md/studies/recqe4sLX2HH2Tqfj 2/2