The safety and efficiency of benzoyl peroxide for reducing Cutibacterium acnes in the shoulder: An updated systematic review and meta-analysis

( ), a common pathogen, contributes significantly to infections in shoulder surgery. Prevention of shoulder infection is crucial to improve postoperative functional recovery and reduce costs. This study aimed to perform a systematic review and meta-analysis to assess the safety and efficacy of 5% benzoyl peroxide (BPO) application in the shoulder to decrease . Three electronic databases were searched as follows: PubMed, Embase, and the Cochrane Library databases. Data extraction for this study was performed by two independent reviewers, and only level I and level II studies were included. The outcome data sources of individual studies were pooled. The fixed-effect model was used to determine the meta-analysis. There were five level I studies and five level II studies. The results showed that the 5% BPO group had a lower risk of positivity [OR, 0.21 (0.15, 0.30), = 24,