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Do Prophylactic Postoperative Antibiotics Prevent Sacral Neuromodulation Infections?

Ashley J Murillo1, Caroline Lindsey2, Christopher J Chermansky3

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Postoperative antibiotics after sacral neuromodulation (SNM) did not reduce infection rates. This study suggests current practices may not be beneficial, highlighting a need for evidence-based guidelines for SNM antibiotic use.

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Area of Science:

  • Urology
  • Neurosurgery
  • Infectious Disease

Background:

  • Practice patterns for postoperative antibiotic use following sacral neuromodulation (SNM) lack definitive guidelines.
  • This variability can lead to inconsistent patient care and outcomes.

Purpose of the Study:

  • To evaluate if postoperative antibiotics, in addition to standard preoperative antibiotics and surgical preparation, reduce infection rates after SNM.
  • To determine if additional postoperative antibiotics are associated with other complications.

Main Methods:

  • A single-center, retrospective cohort study included 212 sacral neuromodulation procedures performed between 2014 and 2023.
  • Patients were divided into two groups: those receiving only preoperative antibiotics and those receiving both preoperative and postoperative antibiotics.

Main Results:

  • No significant difference in infection rates was observed between the group receiving only preoperative antibiotics (0.9%) and the group receiving both (1.9%) (P = 0.99).
  • Overall infection rate was low (2.8%), with no clear benefit of additional postoperative antibiotics.
  • Infected patients showed higher rates of hypertension and diabetes mellitus.

Conclusions:

  • Additional postoperative antibiotics do not appear to decrease infection rates in patients undergoing sacral neuromodulation.
  • Further research with larger sample sizes is recommended to confirm these findings and inform clinical guidelines.