Antibiotic Microbial Prophylaxis for Spinal Surgery: Comparison between 48 and 72-Hour AMP Protocols

Area of Science:

• Orthopedic Surgery
• Infectious Disease Prevention
• Clinical Efficacy Studies

Background:

• Current guidelines recommend limited antibiotic prophylaxis (≤24 hours) post-spinal surgery.
• Clinical practice shows variability in postoperative antibiotic duration due to weak evidence supporting guidelines.
• There is a need to clarify optimal antibiotic prophylaxis duration to prevent surgical site infections (SSI).

Purpose of the Study:

• To compare the efficacy of a 48-hour antibiotic prophylaxis protocol versus a 72-hour protocol.
• To evaluate the impact of prophylaxis duration on surgical site infection (SSI) rates in spinal surgery patients.
• To provide evidence-based recommendations for antibiotic use in spinal surgery.

Main Methods:

• Prospective randomized cohort study involving 548 patients undergoing spinal surgery.
• Patients were assigned to either a 48-hour or 72-hour antibiotic prophylaxis (AMP) group.
• Surgical site infection (SSI) incidence was analyzed at 6-month follow-up for 502 patients.

Main Results:

• The overall surgical site infection (SSI) rate was 0.8%.
• No statistically significant difference in SSI rates was observed between the 48-hour and 72-hour AMP groups.
• This finding held true even for patients who underwent instrumented fusion surgery.

Conclusions:

• A 48-hour antibiotic prophylaxis (AMP) regimen is as effective as a 72-hour regimen for preventing surgical site infections (SSI) in spinal surgery.
• The study supports the use of shorter antibiotic durations, potentially reducing antibiotic exposure and costs.
• Findings suggest that current clinical practice may benefit from adhering to shorter, evidence-based prophylaxis durations.