Erica Bergeron, PharmD
Pediatric PGY-2 Resident
Lee Health, United States
Disclosure information not submitted.
Ryan Hire, PharmD, BCPS, BCCCP
ICU Pharmacist
Lee Health, United States
Disclosure information not submitted.
Elisabeth Chandler, PharmD, BCIDP
Infectious Disease Clinical Specialist
Lee Health, United States
Disclosure information not submitted.
Vera Rosado-Odom, MD
Infectious Disease
Lee Health, United States
Disclosure information not submitted.
Title: Antibiotic prophylaxis in post-operative in neurosurgical patients with a drain: brief vs extended
Introduction/Hypothesis: Current guidelines recommend pre-operative and intra-operative antibiotics to reduce the risk of surgical site infections (SSIs) in neurosurgical patients, but post-operative antibiotic prophylaxis duration with drain placement remains controversial. The purpose of the study was to compare the incidence of SSIs in patients receiving extended versus brief antibiotic prophylaxis following neurosurgical drain placement (NDP).
Methods: This was a retrospective chart review conducted in adults that required NDP and received at least one dose of post-operative antibiotics within a community health-system between May 2020 and September 2020. The primary outcome of this study was the incidence of SSIs following NDP.
Results: A total of 177 patients were included for analysis (74 patients encompassing the brief group (BG) and 103 patients in the extended group (EG). The baseline patient demographics were similar between the two groups. For the primary outcome, the EG group had more SSIs compared to the BG; however, this did not reach statistical significance (1.35% vs 4.85%; p = 0.204). The EG group had significantly longer duration of prophylactic antibiotic (0.7 days vs. 2.1 days; p < 0.001), hospital length of stay (LOS) (3 days vs. 4 days; p = 0.029), and postsurgical hospital LOS (3 days vs. 4 days; p = 0.011). Ninety-day readmissions specifically due to SSIs was not statistically significant (1.4% vs 3.9%; p = 0.316). However, the EG had greater all cause 90-day readmission rates (5.4% vs. 16.5%; p = 0.024).
Conclusions: This study demonstrated no statistical difference in SSIs following NDP between patients that received extended versus brief antibiotic prophylaxis. Therefore, this confirms the recommendations reported in current literature to limit postoperative antibiotic duration to 24 hours after neurosurgery, regardless of NDP.