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Dexamethasone and surgical-site infection

New England Journal of Medicine May 10, 2021

Corcoran TB, Myles PS, Forbes AB, et al. - Since there is a concern that glucocorticoid dexamethasone may elevate the risk of surgical-site infection, therefore, to clarify this, researchers undertook this pragmatic, international, noninferiority trial with 8,880 adult patients who were receiving nonurgent, noncardiac surgery of at least 2 hours’ duration, with a skin incision length longer than 5 cm and a postoperative overnight hospital stay. These patients were randomized to receive 8 mg of intravenous dexamethasone or matching placebo while under anesthesia. Surgical-site infection within 30 days post-surgery was the primary outcome. There were 8678 patients in the primary analysis, among these, 8.1% assigned to dexamethasone and 9.1% assigned to placebo developed surgical-site infection. Findings demonstrated the noninferiority of dexamethasone to placebo in terms of surgical-site infection incidence within 30 days following nonurgent, noncardiac surgery.

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