Meta-analysis of antibiotics in tube thoracostomy.

The use of antibiotics for patients undergoing tube thoracostomy was determined to be highly variable based on a study conducted at a national meeting of surgeons. A meta-analysis of six randomized studies previously reported was performed. The analysis was carried out using the Confidence Profile Method software FAST*PRO. The meta-analysis was structured using dichotomous outcomes of infectious chest processes (empyema, effusion, pneumonia, wound infection, tracheitis, etc.) versus no infectious chest process in patients with and without antibiotics. The effect measures calculated included actual difference in probabilities, relative risk, percent differences in probabilities, and odds ratio. The results of this meta-analysis suggest that antibiotics should be used in patients undergoing tube thoracostomy. Antibiotic selection should maximize therapy for Staph. aureus. The implementation of this practice guideline will require the co-operation of multiple specialty oriented physicians and surgeons.