Nine RCTs with a total of 1,773 participants were included in the review.
Based on 5 trials (n=886), topical ampicillin resulted in a statistically significant reduction in wound infection associated with clean contaminated wounds (OR 0.084, 95% confidence interval, CI: 0.044, 0.164, P<0.0001). There was evidence of statistically significant heterogeneity (chi-squared 55.72, P<0.001).
Based on 3 trials (n=188), topical ampicillin showed a statistically significant reduction in surgical wound infections associated with contaminated wounds (OR 0.262, 95% CI: 0.136, 0.505, P<0.0001). There was evidence of statistically significant heterogeneity (chi-squared 17.53, P<0.001).
Based on 4 trials (n=669), there was no statistically significant difference in wound infections between topical ampicillin combined with systemic antibiotic prophylaxis and systemic antibiotic prophylaxis used alone (OR 0.927, 95% CI: 0.271, 1.716). There was no evidence of statistical heterogeneity in this group of studies (chi-squared 1.482, P>0.1)