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Surgical site infection risk not decreased through continuing antibiotics for drain duration

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CHICAGO — Surgical site infection rate is not decreased by continuing postoperative antibiotics for the duration of postoperative drain placement after spinal surgery, according to a recently presented study.

Richelle Takemoto, MD, shared her team’s findings here at the 2011 Annual Meeting of the North American Spine Society.

“Infections of the spine exact a toll on both the patient and the medical system,” Takemoto said. “Given the consequences of infection following spine surgery and the lack of data with regard to the use of antibiotics with drains, our study sought to evaluate the utilization of antibiotics for 24 hours versus antibiotics for the duration the drain is in place — and to determine if there is a difference in incidence of infection between these two groups.”

Richelle Takemoto

The researchers enrolled 315 patients who underwent multilevel thoracolumbar spine surgery requiring a postoperative drain, randomizing these patients into two groups: one which received 24 hours of perioperative antibiotics and one which received antibiotics for the duration of postoperative drain placement. Data on demographics, comorbidities, spine surgery type and surgical site infection were collected.

According to the study results, 13 of the 170 patients (7.6%) who received 24 hours of antibiotics sustained a surgical site infection, while 21 of the 145 patients (14.5%) in the group that received antibiotics for the duration of the postoperative drain sustained a surgical site infection. Takemoto noted this difference was significant.

“Antibiotics should be limited to 24 hours after spine surgery, regardless of the duration a postoperative drain is left in place,” Takemoto concluded.

Reference:

• Ricart-Hoffiz PA, Takemoto R, Park J, et al. Prospective, randomized study of surgical site infections with the use of perioperative antibiotics for 24 hours versus the duration of a drain after spinal surgery. Paper #47. Presented at the 2011 Annual Meeting of the North American Spine Society. Nov. 2-5, 2011. Chicago.
• Disclosure: Takemoto has no relevant financial disclosures.

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