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Perioperative antibiotic prophylaxis in spinal surgery
Ahmed Shawky Abdelgawaad1, Mohammed Hassaan Mohamed El Sadik2, Khalid Mohammed Hassan2
1Department of Orthopaedic and Trauma Surgery, Assiut University Hospitals, 71515 Assiut, Egypt - Spine Center, Helios Klinikum Erfurt, Nordhaeuser Street 7, 99089 Erfurt, Germany.
SICOT-J
|May 11, 2021
Summary
Reducing perioperative antibiotic prophylaxis (PAP) to a single day for clean, non-instrumented lumbar spine surgery is effective. This approach significantly reduces antibiotic overuse without increasing surgical site infection rates.
Area of Science:
- Spinal Surgery
- Infectious Disease
- Pharmacology
Background:
- Perioperative antibiotic prophylaxis (PAP) is frequently overused in clean, non-instrumented lumbar spinal surgeries.
- Local prescribing practices often deviate from North American Spine Society (NASS) guidelines.
Purpose of the Study:
- To evaluate the efficacy of a single-day PAP regimen compared to prolonged use.
- To address the overuse of antibiotics in lumbar spinal surgery.
Main Methods:
- A complete audit cycle was performed on 108 patients undergoing clean, non-instrumented lumbar spinal surgery.
- Group I (n=54) received 1-6 days of IV and oral antibiotics; Group II (n=54) received a single day of IV antibiotics.
- Surgical site infection (SSI) rates were compared between the two groups.
Main Results:
- Only one patient (1.85%) developed SSI in the audit group (Group I).
- The difference in infection rates between the single-day and prolonged antibiotic groups was statistically insignificant.
- A significant gap exists between international standards and local antibiotic prescribing practices.
Conclusions:
- A single-day postoperative antibiotic dose is effective in preventing surgical site infections after non-instrumented lumbar spinal surgery.
- This approach does not increase infection rates and helps curb antibiotic overuse.
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