Single versus multiple dose antibiotic prophylaxis in lumbar disc surgery

Area of Science:

• Neurosurgery
• Infectious Disease Prevention
• Surgical Site Infections

Background:

• Perioperative antibiotics are known to reduce wound infections in lumbar disc surgery.
• Current institutional protocol utilizes a single preoperative antibiotic dose.
• This study aimed to compare infection rates between single and multiple perioperative antibiotic regimens.

Purpose of the Study:

• To evaluate the efficacy of a single preoperative antibiotic dose versus multiple doses in preventing surgical site infections following lumbar diskectomy.
• To determine if a single preoperative antibiotic dose is non-inferior to multiple doses in this patient population.

Main Methods:

• Retrospective chart review of patients undergoing lumbar laminotomy for herniated discs between 1993 and March 1999.
• Comparison of infection rates between a group receiving a single preoperative antibiotic dose (n=201) and a group receiving multiple doses (n=434).
• Infection defined by clinical diagnosis or culture; records reviewed for 6 weeks post-surgery.

Main Results:

• Surgical site infection rate was 1.49% (3/201) in the single dose group and 1.15% (5/435) in the multiple dose group.
• No statistically significant difference in postoperative wound infection rates was observed between the single and multiple antibiotic dose groups.
• The study found comparable safety profiles regarding infection for both antibiotic regimens.

Conclusions:

• A single preoperative antibiotic dose is sufficient for preventing wound infections in lumbar disk surgery.
• These findings support the current practice of single-dose preoperative antibiotics at the institution.
• This approach aligns with early hospital discharge protocols for lumbar diskectomy patients without increasing infection risk.