Perioperative administration of antimicrobials during tibial plateau leveling osteotomy

To evaluate perioperative antimicrobial administration during tibial plateau leveling osteotomy (TPLO) in dogs at the Ontario Veterinary College Health Sciences Centre.

Retrospective case series.

Dogs (n = 184) that had TPLO (n = 226).

Medical records were reviewed and data collected included timing and dosage of pre, intra, and postoperative antimicrobial administration, method of stifle inspection, duration of surgery, duration of anesthesia, development of surgical site infection (SSI), microbiological investigation, implant removal, and possible comorbidities. Univariable analysis was conducted, followed by stepwise forward logistic regression to determine factors associated with SSI.

Of the 225 cases administered perioperative antimicrobials, 96 (42.5%) received appropriate perioperative antimicrobial prophylaxis based on target times for preoperative and intraoperative dosing. Postoperative antimicrobials were administered to 54 (23.9%) of cases. Surgical site infection was documented in 30 (13.3%) cases. Staphylococcus pseudintermedius was isolated from 15/17 (88.2%) SSI from which a bacterium was isolated, with 6/15 (40%) being methicillin-resistant Staphylococcus pseudintermedius (MRSP). Postoperative administration of antimicrobials was protective for SSI (OR 0.1367; P = .0001; 95% CI = 0.021, 0.50). Duration of anesthesia time was associated with the likelihood of development of SSI (OR = 1.0094; P = .001; 95% CI = 1.00, 1.02).

Current practices for administration of antimicrobial prophylaxis during TPLO can be improved. There was no association between timing of antibiotic administration that was inconsistent with the target and development of SSI. Further study into risk factors of TPLO SSI is required.