Efficacy of antimicrobial prophylaxis on the risk of surgical site infections in companion animal surgery: a systematic review and meta-analysis for European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines.

Surgical antimicrobial prophylaxis shows minimal effect on SSI reduction in companion animal surgery.

This systematic review and meta-analysis evaluated the efficacy of surgical antimicrobial prophylaxis in reducing surgical site infections (SSIs) in dogs and cats. The research team, working under the European Network for Optimization of Antimicrobial Therapy (ENOVAT) guidelines, analyzed 15 studies (8 randomized controlled trials and 7 observational studies) across nine surgical procedure categories based on organ systems and wound classification. Using GRADE methodology to assess evidence certainty, the review found that surgical antimicrobial prophylaxis demonstrated only trivial to small clinical effects on SSI incidence across all surgical procedures examined. Notably, no adverse events or mortalities related to SSIs were reported in the included studies. These findings suggest that routine prophylactic antimicrobial administration may not be necessary for all surgical procedures in companion animals, supporting a more judicious approach to antimicrobial use. The results will inform evidence-based ENOVAT treatment guidelines, promoting appropriate antimicrobial stewardship while maintaining surgical safety in veterinary practice.

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