Effects of extended oral antibiotic prophylaxis on surgical site infections after instrumented spinal fusion: a cohort study of 901 patients with a minimum follow-up of 1 year.
Background and purpose -- We aimed to determine whether an extended oral antibiotic prophylaxis protocol may reduce the rate of surgical site infection (SSI) in patients undergoing instrumented spinal fusion. Patients and methods -- This retrospective cohort study comprise 901 consecutive patients s...
| Publicado en: | Acta Orthopaedica Vol. 94; pp. 80 - 87 |
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| Autores principales: | , , , , , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Medical Journals Sweden AB
2023
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=174668773&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 174668773 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 17453674 1BVL jtl: Acta Orthopaedica issn: 17453674 maglogo: N pubinfo: dt: 2023 vid: 94 pid: 59195 pub: Medical Journals Sweden AB artinfo: ui: 174668773 174668773 174668773 10.2340/17453674.2023.9409 174668773 ppf: 80 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Effects of extended oral antibiotic prophylaxis on surgical site infections after instrumented spinal fusion: a cohort study of 901 patients with a minimum follow-up of 1 year. aug: au: MENENDEZ GARCIA, Miguel OTERMIN MAYA, Iñaki LIBRERO LOPEZ, Julian GUTIERREZ DUBOIS, Jorge MANRIQUE CUEVAS, Diego ALAEZ CRUZ, Jose Ignacio AZCONA SALVATIERRA, Leyre AYECHU DIAZ, Isabel HIDALGO OVEJERO, Angel M. affil: Spine Surgery Unit, Department of Trauma and Orthopaedics, Hospital Universitario de Navarra, Pamplona (Navarra), Spain sug: subj: Surgical Wound Infection Drug Therapy Spinal Fusion Methods Postoperative Complications Drug Therapy Antibiotic Prophylaxis Administration, Oral Treatment Outcomes Surgical Wound Infection Risk Factors Risk Assessment Human Male Female Retrospective Design Record Review Prospective Studies Centers for Disease Control and Prevention (U.S.) Odds Ratio Multiple Logistic Regression Bivariate Statistics Descriptive Statistics Confidence Intervals Male Female ab: Background and purpose -- We aimed to determine whether an extended oral antibiotic prophylaxis protocol may reduce the rate of surgical site infection (SSI) in patients undergoing instrumented spinal fusion. Patients and methods -- This retrospective cohort study comprise 901 consecutive patients subjected to spinal fusion between September 2011 and December 2018 with a minimum 1-year follow-up. 368 patients operated on between September 2011 and August 2014 were administered standard intravenous prophylaxis. 533 patients operated on between September 2014 and December 2018 were administered an extended protocol with 500 mg of oral cefuroxime axetil every 12 hours (clindamycin or levofloxacin in allergic individuals) until the removal of sutures. SSI was defined following the Centers for Disease Control and Prevention criteria. The association between risk factors and the incidence of SSI was evaluated by odds ratio (OR) with a multiple logistic regression model. Results -- The bivariate analysis showed a statistically significant association between SSI and the type of prophylaxis used ("extended"' = 1.7% vs. "standard" = 6.2%, p = 0.001), with a lower proportion of superficial SSIs with the extended regimen (0.8% vs. 4.1%, p = 0.001). The multiple logistic regression model showed an OR = 0.25 (95% confidence interval [CI] 0.10-0.53) for extended prophylaxis and an OR = 3.5 (CI 1.3-8.1) for non-beta-lactams antibiotics. Conclusion -- Extended antibiotic prophylaxis seems to be associated with a reduction in the incidence of superficial SSI in instrumented spine surgery. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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