# Twenty-four-hour antibiotic prophylaxis × Reduced exposure duration — Evidence sheet distinguishing medians and infection outcomes

Verdict 2934 · Evidence Check

Stored-material review date: Not recorded  
Original evidence cut-off: 2026-08-26  
Review-criteria version: 1.0  
Public page/material preparation date: 2026-10-10

Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect.

## Assessment scope

- Population: Patients undergoing open cystectomy and urinary diversion at a single Swiss center; original eligibility and baseline details remain unread
- Ingredient, formulation and route: Historical study condition of stopping prophylactic antibiotics 24 hours after surgery; not instructions on duration or use
- Dose: Drug-combination, dose and concomitant-use details remain unread; no individual antibiotic choice, use or stopping guidance is generated
- Comparator: Prophylactic antibiotics continued until catheter and stent removal; original median 8 days
- Measured outcome: Reduced median prophylactic-antibiotic duration; 1 day versus 8 days and the original 7-day/87.5% reduction are distinguished from direct SSI and harm outcomes
- Duration: Original SSI and mortality at 90 days; prophylaxis duration of 1 day (IQR1~1) versus 8 days (IQR7~10) is a historical exposure statistic
- Questions outside this scope: Converting noninferiority into SSI superiority or exact equivalence; Converting median exposure into mean total exposure or the same reduction for each individual; Converting exposure or mechanism into direct reductions in resistance, costs or all harms; Certifying 193-participant PP as all-randomized 196-participant ITT or as the exposure denominator; Recommendations on antibiotic type, duration, use, stopping or treatment substitution

## Checklist items

### N01 · Are the original subclaim and grade distinguished from the parent judgment context?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The selected claim is reduced antibiotic exposure, with subclaim grade C and a note that the median fell from 8 days to 1 day. The parent verdict is C, 56 points, Caution.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Absent subclaim score, status and axes are not filled with parent values. This production does not establish a new verdict or grade certification.
- Reason for missing information: Absent subclaim score, status and axes are not filled with parent values. This production does not establish a new verdict or grade certification.
- Required materials and conditions: Separate records of the selected subclaim, grade and note, and the original parent verdict
- Materials to obtain first: Absent subclaim score, status and axes are not filled with parent values. This production does not establish a new verdict or grade certification.
- Further research: Link additional materials separately to the relevant subclaim and parent context.
- Conditions for verification: Separate records of the selected subclaim, grade and note, and the original parent verdict
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N02 · What surgery, population and center were actually studied?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: PAPRAC included patients undergoing open cystectomy and urinary diversion at a single Swiss center.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. The preserved summary lacks detailed tables of age, eligibility exclusions, baseline risk and surgical details. Results are not automatically extended to robotic surgery or other populations.
- Reason for missing information: The preserved summary lacks detailed tables of age, eligibility exclusions, baseline risk and surgical details. Results are not automatically extended to robotic surgery or other populations.
- Required materials and conditions: Eligibility, surgery type, urinary diversion, baseline characteristics and denominators
- Materials to obtain first: The preserved summary lacks detailed tables of age, eligibility exclusions, baseline risk and surgical details. Results are not automatically extended to robotic surgery or other populations.
- Further research: Obtain the original eligibility, baseline characteristics, surgery, center and denominator records.
- Conditions for verification: Eligibility, surgery type, urinary diversion, baseline characteristics and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N03 · What were the historical intervention and comparator exposure until catheter and stent removal?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original study conditions were stopping prophylactic antibiotics 24 hours after surgery in the short arm and continuing until catheter and stent removal in the extended arm.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. No individual antibiotic type, duration, use or stopping recommendation is made. Details of exact drug combinations, doses, concomitant drugs and additional treatment exposure remain unread.
- Reason for missing information: No individual antibiotic type, duration, use or stopping recommendation is made. Details of exact drug combinations, doses, concomitant drugs and additional treatment exposure remain unread.
- Required materials and conditions: Original intervention, comparator, stopping criteria, actual exposure and accompanying care
- Materials to obtain first: No individual antibiotic type, duration, use or stopping recommendation is made. Details of exact drug combinations, doses, concomitant drugs and additional treatment exposure remain unread.
- Further research: Obtain the original arm-specific tables of drugs, prophylactic and treatment exposure, actual duration and accompanying care.
- Conditions for verification: Original intervention, comparator, stopping criteria, actual exposure and accompanying care
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N04 · Are 196 randomized participants distinguished from 193 in the primary analysis and denominators 95/98?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: After 196 participants were randomized, the prespecified per-protocol primary analysis included 193 (95/98), excluding 3 canceled surgeries.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. The summary lacks original arm-specific randomized counts, cancellations by arm and additional follow-up losses. No new totals, dropout rates or certification of an all-randomized ITT analysis are produced.
- Reason for missing information: The summary lacks original arm-specific randomized counts, cancellations by arm and additional follow-up losses. No new totals, dropout rates or certification of an all-randomized ITT analysis are produced.
- Required materials and conditions: Arm-specific randomization, canceled surgery, analysis and follow-up flow
- Materials to obtain first: The summary lacks original arm-specific randomized counts, cancellations by arm and additional follow-up losses. No new totals, dropout rates or certification of an all-randomized ITT analysis are produced.
- Further research: Obtain the original participant flow, exclusion reasons, arm-specific allocation and analysis counts, and missing-data tables.
- Conditions for verification: Arm-specific randomization, canceled surgery, analysis and follow-up flow
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N05 · Are the open-label design and infection adjudicators' roles distinguished?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original design was a single-center open-label noninferiority randomized trial. The record states that infectious-disease specialists and clinicians not involved in care adjudicated 90-day CDC-defined SSI.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Non-involvement in care is not newly certified as blinding to allocation. Details of allocation concealment, assessor blinding and analyst independence remain unread.
- Reason for missing information: Non-involvement in care is not newly certified as blinding to allocation. Details of allocation concealment, assessor blinding and analyst independence remain unread.
- Required materials and conditions: Allocation, concealment, measurement, adjudicator and analyst procedures
- Materials to obtain first: Non-involvement in care is not newly certified as blinding to allocation. Details of allocation concealment, assessor blinding and analyst independence remain unread.
- Further research: Obtain the original allocation, adjudication, blinding and analysis procedures.
- Conditions for verification: Allocation, concealment, measurement, adjudicator and analyst procedures
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N06 · What is the actual access status of registration, protocol and analysis-plan materials?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The registration identifier in the original evidence list is NCT03305627. The preserved summary records a prespecified per-protocol primary analysis and a prespecified 10%p margin.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. No new URL was constructed from the registration identifier, and registration, full text and plans were not read. Details of the original primary/secondary exposure hierarchy and testing plan remain unread.
- Reason for missing information: No new URL was constructed from the registration identifier, and registration, full text and plans were not read. Details of the original primary/secondary exposure hierarchy and testing plan remain unread.
- Required materials and conditions: Original registration, protocol, SAP, outcome hierarchy and amendment history
- Materials to obtain first: No new URL was constructed from the registration identifier, and registration, full text and plans were not read. Details of the original primary/secondary exposure hierarchy and testing plan remain unread.
- Further research: Obtain the original registration, plans, analysis populations, hierarchy, amendments and multiplicity information.
- Conditions for verification: Original registration, protocol, SAP, outcome hierarchy and amendment history
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N07 · What quantity does the antibiotic-exposure outcome actually measure?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The selected question is reduced prophylactic antibiotic exposure; the original median durations are 1 day versus 8 days.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. This is not converted into mean total drug quantity, fewer use days for each individual or exposure to all therapeutic antibiotics. Details of drug-specific doses and the distinction between prophylaxis and additional treatment remain unread.
- Reason for missing information: This is not converted into mean total drug quantity, fewer use days for each individual or exposure to all therapeutic antibiotics. Details of drug-specific doses and the distinction between prophylaxis and additional treatment remain unread.
- Required materials and conditions: Duration, distinction between prophylaxis and treatment, summary statistics and denominators
- Materials to obtain first: This is not converted into mean total drug quantity, fewer use days for each individual or exposure to all therapeutic antibiotics. Details of drug-specific doses and the distinction between prophylaxis and additional treatment remain unread.
- Further research: Obtain the original exposure definition, drug-specific duration/total quantity, denominators and distinction from additional treatment.
- Conditions for verification: Duration, distinction between prophylaxis and treatment, summary statistics and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N08 · Are medians of 1 day and 8 days and their respective IQRs preserved?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original text records duration as 1 day (IQR1~1) versus 8 days (IQR7~10).
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. IQR is not converted into CI, mean, range or identical exposure for every individual. Detailed distributions, original denominators and CI for the between-arm estimate remain unread.
- Reason for missing information: IQR is not converted into CI, mean, range or identical exposure for every individual. Detailed distributions, original denominators and CI for the between-arm estimate remain unread.
- Required materials and conditions: Arm-specific exposure duration, median, IQR and denominators
- Materials to obtain first: IQR is not converted into CI, mean, range or identical exposure for every individual. Detailed distributions, original denominators and CI for the between-arm estimate remain unread.
- Further research: Obtain original duration distributions, summary statistics, arm-specific denominators and uncertainty information.
- Conditions for verification: Arm-specific exposure duration, median, IQR and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N09 · Is the original reduction of 7 days and 87.5% preserved without new calculation?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original materials record a reduction in median duration from 8 days to 1 day, by 7 days and 87.5%.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. No new calculation, total days saved, relative effect, 7-day reduction for each individual, CI or P value is produced. A median difference is not transferred to an effect for every individual.
- Reason for missing information: No new calculation, total days saved, relative effect, 7-day reduction for each individual, CI or P value is produced. A median difference is not transferred to an effect for every individual.
- Required materials and conditions: Original reduction wording, arm order, exposure statistics and estimation scope
- Materials to obtain first: No new calculation, total days saved, relative effect, 7-day reduction for each individual, CI or P value is produced. A median difference is not transferred to an effect for every individual.
- Further research: Obtain the original reduction definition, denominators, original statistics, testing and CI.
- Conditions for verification: Original reduction wording, arm order, exposure statistics and estimation scope
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N10 · Are the exposure-analysis denominators, missingness and adherence the same as in the SSI analysis?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The preserved summary records 196 randomized participants, 193 in the PP primary analysis (95/98), and median exposure duration together.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. These counts are not newly certified as the definitive exposure-analysis denominators. Details of outcome-specific exposure missingness, adherence, crossover, additional treatment and duration-recording procedures are unavailable.
- Reason for missing information: These counts are not newly certified as the definitive exposure-analysis denominators. Details of outcome-specific exposure missingness, adherence, crossover, additional treatment and duration-recording procedures are unavailable.
- Required materials and conditions: Original outcome-specific exposure denominators, omissions, actual administration and changes
- Materials to obtain first: These counts are not newly certified as the definitive exposure-analysis denominators. Details of outcome-specific exposure missingness, adherence, crossover, additional treatment and duration-recording procedures are unavailable.
- Further research: Obtain outcome-specific exposure tables of original denominators, adherence, omissions, actual administration and changes.
- Conditions for verification: Original outcome-specific exposure denominators, omissions, actual administration and changes
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N11 · How does the duration difference relate to original stopping criteria and device removal?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: Stopping 24 hours after surgery in the short arm and continuing until catheter and stent removal in the extended arm are the original historical comparison conditions.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Shorter duration is not turned into superiority of another antibiotic type or identical results for all removal times and surgeries. No instructions on implementation or use are provided.
- Reason for missing information: Shorter duration is not turned into superiority of another antibiotic type or identical results for all removal times and surgeries. No instructions on implementation or use are provided.
- Required materials and conditions: Original stopping criteria, catheter/stent removal, additional treatment and exposure
- Materials to obtain first: Shorter duration is not turned into superiority of another antibiotic type or identical results for all removal times and surgeries. No instructions on implementation or use are provided.
- Further research: Obtain original stopping criteria, device-removal timing, additional-treatment and actual-exposure tables.
- Conditions for verification: Original stopping criteria, catheter/stent removal, additional treatment and exposure
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N12 · What gaps remain in the exposure outcome's hierarchy, testing and uncertainty?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original evidence list's core endpoint is 90-day CDC-defined SSI; duration of 1 day versus 8 days appears in the same report.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. The exposure outcome is not newly certified as a prespecified primary endpoint, and P values, CI or effect measures absent from the original text are not filled in.
- Reason for missing information: The exposure outcome is not newly certified as a prespecified primary endpoint, and P values, CI or effect measures absent from the original text are not filled in.
- Required materials and conditions: Original primary/secondary endpoints, plans, testing, CI and denominators
- Materials to obtain first: The exposure outcome is not newly certified as a prespecified primary endpoint, and P values, CI or effect measures absent from the original text are not filled in.
- Further research: Obtain the original exposure-endpoint hierarchy, analysis plan, original testing, denominators and intervals.
- Conditions for verification: Original primary/secondary endpoints, plans, testing, CI and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N13 · Are 90-day SSI events and the noninferiority margin preserved separately from exposure reduction?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: In the same trial, SSI was 8/95 (8.4%) versus 12/98 (12.2%), risk difference −3.8%p (90% CI −11.1~3.4), with a prespecified 10%p margin.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Reduced exposure is not said to establish infection superiority, exact equivalence or safety for all infections. 90% is not changed to 95%, and no new P value is generated.
- Reason for missing information: Reduced exposure is not said to establish infection superiority, exact equivalence or safety for all infections. 90% is not changed to 95%, and no new P value is generated.
- Required materials and conditions: Infection definition, events, duration, original effect, margin and denominators
- Materials to obtain first: Reduced exposure is not said to establish infection superiority, exact equivalence or safety for all infections. 90% is not changed to 95%, and no new P value is generated.
- Further research: Link the original SSI analysis, margin and denominators separately through the related question.
- Conditions for verification: Infection definition, events, duration, original effect, margin and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N14 · Has short-term exposure reduction been kept separate from long-term resistance and clinical benefits?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The preserved summary provides a stewardship explanation for shorter duration but states that the trial did not directly test individual resistance or costs.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Exposure or mechanistic signals are not used to fill in direct effects on long-term resistance, all infections, mortality or cost reduction.
- Reason for missing information: Exposure or mechanistic signals are not used to fill in direct effects on long-term resistance, all infections, mortality or cost reduction.
- Required materials and conditions: Direct long-term clinical outcomes, resistance, costs, follow-up and denominators
- Materials to obtain first: Exposure or mechanistic signals are not used to fill in direct effects on long-term resistance, all infections, mortality or cost reduction.
- Further research: Obtain long-term direct measurements, denominators, reports and analysis materials for the relevant outcomes.
- Conditions for verification: Direct long-term clinical outcomes, resistance, costs, follow-up and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N15 · Has the exposure effect of the specific 24-hour comparison been extended to other durations or settings?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original trial compared specific stopping criteria in open surgery with urinary diversion at a single Swiss center.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. The same exposure effect is not certified for all short antibiotic regimens, other surgeries or different resistance environments. No guidance on selecting duration, use or stopping is produced.
- Reason for missing information: The same exposure effect is not certified for all short antibiotic regimens, other surgeries or different resistance environments. No guidance on selecting duration, use or stopping is produced.
- Required materials and conditions: Direct comparisons by duration, drugs, surgery, center and setting
- Materials to obtain first: The same exposure effect is not certified for all short antibiotic regimens, other surgeries or different resistance environments. No guidance on selecting duration, use or stopping is produced.
- Further research: Obtain direct comparisons and harm information for new durations, centers, surgeries and drug combinations.
- Conditions for verification: Direct comparisons by duration, drugs, surgery, center and setting
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N16 · Are the two subclaims from the same trial kept separate from independent replications?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: One PAPRAC report records both 90-day SSI and antibiotic duration, so the two subclaim tables share the same trial and population.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Report entries, two questions, outcomes and time points are not added as new independent trials or participants. Final independent-study and total-participant counts remain unrecorded.
- Reason for missing information: Report entries, two questions, outcomes and time points are not added as new independent trials or participants. Final independent-study and total-participant counts remain unrecorded.
- Required materials and conditions: Relationships among report, trial, shared participants, outcomes and related questions
- Materials to obtain first: Report entries, two questions, outcomes and time points are not added as new independent trials or participants. Final independent-study and total-participant counts remain unrecorded.
- Further research: Link additional reports while preserving original identifiers and population and time-point relationships.
- Conditions for verification: Relationships among report, trial, shared participants, outcomes and related questions
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N17 · What is known about company and institutional funding, in-kind support, affiliations and analysis roles?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original summary records no reported external grant or company in-kind support, and sponsorship and conduct by Insel Gruppe AG and University Hospital Bern.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. No reported support is not converted into certification of no support or company involvement. Separate details of employee authors, external analysis, design and writing roles remain unread.
- Reason for missing information: No reported support is not converted into certification of no support or company involvement. Separate details of employee authors, external analysis, design and writing roles remain unread.
- Required materials and conditions: Cash, products/in-kind support, author affiliations, external analysis and study roles
- Materials to obtain first: No reported support is not converted into certification of no support or company involvement. Separate details of employee authors, external analysis, design and writing roles remain unread.
- Further research: Obtain the original support, in-kind, affiliation, analysis, design and writing disclosures separately.
- Conditions for verification: Cash, products/in-kind support, author affiliations, external analysis and study roles
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N18 · Are 90-day mortality counts, denominators and P distinguished from SSI?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original safety record gives 90-day all-cause mortality as 6/95 (6.3%) versus 5/98 (5.1%), P=.96.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. These results are not converted into antibiotic-related mortality, survival noninferiority or absence of rare harms. CI, causes, relatedness and hierarchy for the original mortality outcome remain unread, with no new calculation.
- Reason for missing information: These results are not converted into antibiotic-related mortality, survival noninferiority or absence of rare harms. CI, causes, relatedness and hierarchy for the original mortality outcome remain unread, with no new calculation.
- Required materials and conditions: Mortality definition, duration, arm-specific denominators, original events and testing
- Materials to obtain first: These results are not converted into antibiotic-related mortality, survival noninferiority or absence of rare harms. CI, causes, relatedness and hierarchy for the original mortality outcome remain unread, with no new calculation.
- Further research: Obtain original mortality, relatedness, denominator, plan, CI and follow-up materials.
- Conditions for verification: Mortality definition, duration, arm-specific denominators, original events and testing
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N19 · What do the infection-resolution statement and treatment and safety collection cover?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The original safety record states that all infections resolved with appropriate treatment.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. This statement is not extended to mean no infections, systematic collection of all harms or no risk. Details of other infections, treatments, people/events and recovery timing remain unread.
- Reason for missing information: This statement is not extended to mean no infections, systematic collection of all harms or no risk. Details of other infections, treatments, people/events and recovery timing remain unread.
- Required materials and conditions: Infection types, treatment exposure, follow-up, recovery, relatedness and denominators
- Materials to obtain first: This statement is not extended to mean no infections, systematic collection of all harms or no risk. Details of other infections, treatments, people/events and recovery timing remain unread.
- Further research: Obtain original infection, treatment-exposure, treatment-success definition, follow-up, relatedness and denominator records.
- Conditions for verification: Infection types, treatment exposure, follow-up, recovery, relatedness and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N20 · Does shorter antibiotic exposure directly demonstrate reduced harms?

Verification status: Unverified  
Reading scope: Summary read; external materials not read

- Current findings: The original materials record shorter prophylactic antibiotic exposure, 90-day SSI and mortality; parent safety is Caution.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Shorter exposure alone does not newly establish reductions in adverse drug reactions, kidney injury, allergy or other harms. The summary lacks the relevant original outcomes, denominators and collection details.
- Reason for missing information: Shorter exposure alone does not newly establish reductions in adverse drug reactions, kidney injury, allergy or other harms. The summary lacks the relevant original outcomes, denominators and collection details.
- Required materials and conditions: Drug harms, collection, exposure, arm-specific events and denominators
- Materials to obtain first: Shorter exposure alone does not newly establish reductions in adverse drug reactions, kidney injury, allergy or other harms. The summary lacks the relevant original outcomes, denominators and collection details.
- Further research: Obtain original harm-collection records, arm-specific events/people, exposure, discontinuation, relatedness and duration.
- Conditions for verification: Drug harms, collection, exposure, arm-specific events and denominators
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N21 · Are resistance selection pressure, individual resistance, costs and other infections distinguished?

Verification status: Unverified  
Reading scope: Summary read; external materials not read

- Current findings: The original review summary records both a possible reduction in resistance selection pressure and costs through less exposure, and the limitation that individual resistance emergence and costs were not directly tested.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Mechanistic or stewardship advantages are not converted into established direct reductions in resistance or costs or prevention of other infections.
- Reason for missing information: Mechanistic or stewardship advantages are not converted into established direct reductions in resistance or costs or prevention of other infections.
- Required materials and conditions: Direct outcomes, definitions and denominators for resistance, costs and infection types
- Materials to obtain first: Mechanistic or stewardship advantages are not converted into established direct reductions in resistance or costs or prevention of other infections.
- Further research: Obtain prespecified direct measurements, denominators, effects and follow-up for resistance, costs and other infections.
- Conditions for verification: Direct outcomes, definitions and denominators for resistance, costs and infection types
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N22 · What application gaps remain for populations, surgery, drugs and resistance environments outside the single center?

Verification status: Unverified  
Reading scope: Summary read; external materials not read

- Current findings: The parent counterview records that results cannot be directly applied to robotic surgery, other antibiotic combinations or different resistance environments.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. No individual antibiotic choice, duration, postoperative-care or treatment-substitution guidance is generated. Efficacy and safety outside the original study conditions are not newly certified.
- Reason for missing information: No individual antibiotic choice, duration, postoperative-care or treatment-substitution guidance is generated. Efficacy and safety outside the original study conditions are not newly certified.
- Required materials and conditions: Direct comparisons in new populations, surgeries, drug combinations and settings
- Materials to obtain first: No individual antibiotic choice, duration, postoperative-care or treatment-substitution guidance is generated. Efficacy and safety outside the original study conditions are not newly certified.
- Further research: Obtain direct effects/harms, denominators and follow-up for each new population, surgery, drug and setting.
- Conditions for verification: Direct comparisons in new populations, surgeries, drug combinations and settings
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N23 · Do gaps remain in durability beyond 90 days and independent replication?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The currently designated preserved summary contains one PAPRAC report and 90-day SSI.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Duration, outcomes and related tables are not counted as replication trials or extended to long-term resistance, readmission, mortality or all infections.
- Reason for missing information: Duration, outcomes and related tables are not counted as replication trials or extended to long-term resistance, readmission, mortality or all infections.
- Required materials and conditions: Long-term follow-up, new trials, populations, centers and independence relationships
- Materials to obtain first: Duration, outcomes and related tables are not counted as replication trials or extended to long-term resistance, readmission, mortality or all infections.
- Further research: Obtain long-term direct outcomes, independent-report relationships and center-specific materials.
- Conditions for verification: Long-term follow-up, new trials, populations, centers and independence relationships
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N24 · Are the preserved summary and external abstract, full text, registration and plans distinguished?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: The complete parent-verdict summary was read for production, linking the existing PubMed URL for Thurnheer et al. 2024, PMID39422911 and identifier NCT03305627.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. External abstract, full text, registration, protocol and SAP remain unread; no separate link test was performed. No new URL or DOI is constructed from identifiers.
- Reason for missing information: External abstract, full text, registration, protocol and SAP remain unread; no separate link test was performed. No new URL or DOI is constructed from identifiers.
- Required materials and conditions: Bibliography, existing links, registration identifiers and material-specific access status
- Materials to obtain first: External abstract, full text, registration, protocol and SAP remain unread; no separate link test was performed. No new URL or DOI is constructed from identifiers.
- Further research: Link individual original materials supplied by the user separately from their actual access status.
- Conditions for verification: Bibliography, existing links, registration identifiers and material-specific access status
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

### N25 · Are the reference date, Korean/English texts, corrections, empty values, candidate history and production state preserved?

Verification status: Partly verified  
Reading scope: Summary read; external materials not read

- Current findings: 2026-08-26, empty correction and deliberation values, Korean/English texts, parent C56, Caution and axes, and the subclaim C grade and note are preserved in their original form.
- Why unverified: Only the relevant preserved-summary information is recorded; detailed original materials are unread and existing content review remains incomplete. Original statements, including the sample-size wording in the parent rationale, remain historical records without new correction or reassessment. Original review-pending and production-eligibility indicators are candidate history, not current review or completion.
- Reason for missing information: Original statements, including the sample-size wording in the parent rationale, remain historical records without new correction or reassessment. Original review-pending and production-eligibility indicators are candidate history, not current review or completion.
- Required materials and conditions: Distinguishing the complete preserved summary, selected verdict record, parent values, original languages and history
- Materials to obtain first: Original statements, including the sample-size wording in the parent rationale, remain historical records without new correction or reassessment. Original review-pending and production-eligibility indicators are candidate history, not current review or completion.
- Further research: Preserve original texts before linking additional user materials or decisions as separate events.
- Conditions for verification: Distinguishing the complete preserved summary, selected verdict record, parent values, original languages and history
- Why this condition is needed: Individual production conditions recording original selected claims, comparisons, denominators, periods and interpretive limits
- Application exceptions: Unread external material, other questions or out-of-scope outcomes do not substitute for satisfied conditions, zero effect or safety.
- Remaining uncertainty: Unread/unverified does not mean zero effect, zero events, safety or new clinical certification.
- Referenced methods: Reduced antibiotic exposure
- Related sources: R01

## Evidence and sources

### R01

Thurnheer MC, et al. JAMA Netw Open. 2024;7:e2439382. PMID: 39422911.

[PubMed](https://pubmed.ncbi.nlm.nih.gov/39422911/)

Materials actually read: Summary read; external materials not read  
Findings recorded in the summary: 8.4% versus 12.2%, risk difference −3.8%p (90% CI −11.1~3.4), margin 10%p; duration 1 versus 8 days  
Record level: Preserved summary; not a result of newly comparing the external original report  
Independent replication: The same PAPRAC report and population for 90-day SSI and prophylactic-antibiotic exposure duration; shared by the two subclaims

| Material | Public availability | Access status | Actually read | Notes |
|---|---|---|---|---|
| local_summary | Existing link preserved | Summary read | Summary read | Stored parent-verdict summary |
| abstract | Existing link preserved | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review |
| fulltext | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review |
| registration | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review |
| protocol_sap | No separate URL in the original material | Not read | Not read | External material unread; a URL does not mean acquisition, reading or completed review |

## Review criteria and methods

These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score.

- M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed.
- M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed.
- M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed.
- M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed.
- M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Preserved methodology connections were reused for preparation. No new review of methodological content, reassessment or external-link checks were performed.

## What the statuses mean

- Partly verified: Some information exists in the preserved review summary, with detailed original materials still unverified; no certification of a passed review or clinical efficacy
- Unverified: Detailed materials for the selected condition could not be established within the stored scope; this does not mean zero effect, zero studies or safety
- Review incomplete: Existing content review pending
- Met: Use only within the relevant conditions after existing content review; no automatic designation in this preparation
- Not reported: Distinguish only within materials actually read; do not turn unread external materials into unreported findings
- Inaccessible: Not applied during this preparation because actual access was not tested
- Not applicable: Use with a reason for non-applicability based on an explicit question boundary
- Conflicting data: Judge after actual material comparison; review was not performed during this preparation
- Insufficient evidence for the conditions: Do not use as a clinical grade encompassing currently unread materials

## Change history

2026-10-10 · Public page/materials 1.0. The public page and data were prepared from the existing 25 items. No new clinical search, verification-status change or scoring was performed.