Single Versus Multiple Dose Antibiotic Prophylaxis in Lumbar Disc Surgery

Dobzyniak, Matthew; Fischgrund, Jeffrey S.; Hankins, Steve; Herkowitz, Harry N.

doi:10.1097/01.brs.0000090839.61893.be

Cited by 47 publications

(46 citation statements)

References 6 publications

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“…The majority of available studies of antimicrobial prophylaxis in spinal procedures have used single doses or regimens of <24 hours' duration. 732 There is no high-quality evidence supporting a duration of >24 hours, 782 and some sources recommend only a single preoperative dose. 8,769,778 Pediatric efficacy.…”

Section: Spinal Procedures With and Without Instrumentationmentioning

confidence: 99%

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Bratzler

Dellinger

Olsen

et al. 2013

American Journal of Health-System Pharmacy

1,832

1,464

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Section: Spinal Procedures With and Without Instrumentationmentioning

confidence: 99%

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Bratzler

Dellinger

Olsen

et al. 2013

American Journal of Health-System Pharmacy

1,832

1,464

View full text Add to dashboard Cite

“…A recent study conducted at our center revealed the incidence of infection to be 2.7% [60]. Clearly, aseptic technique and appropriate antibiotic prophylaxis have dramatically reduced infection rates in the perioperative period [61]. Infection may also occur after lumbar puncture, myelogram, cervical laminectomy, lumbar sympathectomy, discography, chemonucleolysis and other procedures.…”

Section: Postoperative and Iatrogenic Spondylodiscitismentioning

confidence: 98%

Pyogenic spondylodiscitis: An overview

Skaf

Domloj

Fehlings

et al. 2010

Journal of Infection and Public Health

202

152

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Although uncommon, spontaneous and postoperative pyogenic spondylodiscitis entail major morbidity and may be associated with serious long-term sequelae. A review of the literature was done to advance our understanding of the diagnosis, treatment, and outcome of these infections. The principles of conservative treatment are to establish an accurate microbiological diagnosis, treat with appropriate antibiotics, immobilize the spine, and closely monitor for spinal instability and neurological deterioration. The purpose of surgical treatment is to obtain multiple intraoperative cultures of bone and soft tissue, perform a thorough debridement of infected tissue and decompression of neural structures, and reconstruct the unstable spinal column with bone graft with or without concomitant instrumentation. Appropriate management requires aggressive medical treatment and, at times, surgical interventions. If recognized early and treated appropriately, a full recovery can often be expected. Therefore, clinicians should be aware of the clinical presentation of such infections to improve patient outcome.

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“…Notably, no other findings proved significant (e.g., the antibiotic utilized, the dosage protocol, the schedule for redosing antibiotics, and the duration of postoperative prophylactic antibiotics). [103233606771148]…”

Section: Prevention Of Spinal Implant Infectionmentioning

confidence: 99%

Infection with spinal instrumentation: Review of pathogenesis, diagnosis, prevention, and management

Kasliwal

Tan²,

Traynelis³

2013

Surg Neurol Int

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Background:Instrumentation has become an integral component in the management of various spinal pathologies. The rate of infection varies from 2% to 20% of all instrumented spinal procedures. Every occurrence produces patient morbidity, which may adversely affect long-term outcome and increases health care costs.Methods:A comprehensive review of the literature from 1990 to 2012 was performed utilizing PubMed and several key words: Infection, spine, instrumentation, implant, management, and biofilms. Articles that provided a current review of the pathogenesis, diagnosis, prevention, and management of instrumented spinal infections over the years were reviewed.Results:There are multiple risk factors for postoperative spinal infections. Infections in the setting of instrumentation are more difficult to diagnose and treat due to biofilm. Infections may be early or delayed. C Reactive Protein (CRP) and Magnetic Resonance Imaging (MRI) are important diagnostic tools. Optimal results are obtained with surgical debridement followed by parenteral antibiotics. Removal or replacement of hardware should be considered in delayed infections.Conclusions:An improved understanding of the role of biofilm and the development of newer spinal implants has provided insight in the pathogenesis and management of infected spinal implants. This literature review highlights the mechanism, pathogenesis, prevention, and management of infection after spinal instrumentation. It is important to accurately identify and treat postoperative spinal infections. The treatment is often multimodal and prolonged.

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Single Versus Multiple Dose Antibiotic Prophylaxis in Lumbar Disc Surgery

Abstract: These results support the use of single preoperative dose of antibiotics in lumbar disc surgery. This is relevant as many lumbar diskectomy patients are candidates for early hospital discharge. At our institution, no increased risk of infection occurred for the single dose group.

Cited by 47 publications

References 6 publications

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Clinical practice guidelines for antimicrobial prophylaxis in surgery

Pyogenic spondylodiscitis: An overview

Infection with spinal instrumentation: Review of pathogenesis, diagnosis, prevention, and management

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