Prolonged Antibiotics for Drains After Spine Injury Instrumentation for Trauma: Not Prophylactic or Necessary

Area of Science:

• Orthopedic Surgery
• Infectious Disease Management
• Trauma Care

Background:

• Antibiotic use is frequently extended post-spine instrumentation, especially in trauma cases with surgical drains.
• Current practice often involves prolonged antibiotic courses, but evidence supporting this is limited.

Purpose of the Study:

• To investigate the impact of prolonged antibiotic administration (>24 hours) versus standard perioperative duration (≤24 hours) on surgical outcomes.
• To determine if extended antibiotic use affects surgical site infection rates and mortality following traumatic spine fixation.

Main Methods:

• Retrospective observational study of 346 patients undergoing spine fixation with hardware and drains for trauma.
• Comparison of outcomes between patients receiving perioperative antibiotics (≤24 hours) and those receiving prolonged antibiotics (>24 hours).
• Statistical analysis included bivariate and multivariable logistic and linear regression.

Main Results:

• Multivariate analysis indicated that antibiotic duration >24 hours did not significantly predict surgical site infection (OR, 2.68; 95% CI, 0.88-8.10; P = 0.08).
• Extended antibiotic use was also not associated with a lower risk of mortality (OR, 0.59; 95% CI, 0.10-3.44; P = 0.56).

Conclusions:

• Continuing antibiotics beyond 24 hours after traumatic spine instrumentation is not linked to improved surgical outcomes.
• Further prospective studies are recommended to validate these findings and potentially refine antibiotic guidelines.