Zhonghua yi xue za zhi · 2012
[Impact of short-time treatment of prophylactic antibiotics for surgical site infection in cervical spinal surgery].
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Xiao Bin, Tian Wei, Liu Bo, Lü Yan-wei, Jin Pei-hao, Yan Kai, Zhao Jing-wei, Wang Han
Аннотация
OBJECTIVES: This study is designed to determine the impact of the short-time usage of prophylactic antibiotics to prevent postoperative wound infection in spinal surgery.
METHODS: The medical records of 965 patients who underwent cervical spinal operation between 2009 and 2011 were collected for the assessment. These patients were divided into two groups based on antibiotic selection and duration of prophylactic antibiotic treatment:234 patients treated with prophylactic antibiotics for a short period of time were set as Group A, whereas Group B included 731 patients treated with prophylactic antibiotics for experience-based length of time. All the patients' records, including personal information, preoperational medical records, surgical records, postoperative medical information and the development of surgical site infections, were collected for analysis.
RESULTS: In Group A, 153 patients were treated by second generation cephalosporins and 81 patients were treated by clindamycin. The duration of treatment was 1.17 ± 0.38 days. In Group B, 41 patients were treated by penicillin, 375 and 2 patients were treated by second and third generation cephalosporins, respectively, 128 patients were treated by clindamycin, 42 patients were treated by cephamycin, 128 patients were treated by quinolone, other antibiotic was used by 1 patient and other 14 patients were treated by combinations of antibiotics. The duration of the treatment in Group B was 5.72 ± 1.63 days. The significant differences between the length of treatment time in Group A and B were observed (P < 0.001). There were no statistical differences of pre-/post-operational leukocytes number compared between Group A and B. In addition, although the neutrophils in Group A and B are 70.70% ± 9.71% and 67.09% ± 9.78% respectively, indicating a subtle difference (t = 2.921, P = 0.004), however, these numbers were in normal range; therefore, no clinical significance was found from the comparison of neutrophils in groups. A total of 7 cases (0.73%) of surgical site infection were recorded, including 4 cases (1.71%) in Group A and 3 cases (0.41%) in Group B, all of which were posterior laminoplasty. With Fisher analysis (P = 0.063), these infection rates were not statistically significant.
CONCLUSIONS: An appropriate usage of prophylactic antibiotics in a short period of time in cervical spinal surgery did not increase the rate of surgical site infection.
METHODS: The medical records of 965 patients who underwent cervical spinal operation between 2009 and 2011 were collected for the assessment. These patients were divided into two groups based on antibiotic selection and duration of prophylactic antibiotic treatment:234 patients treated with prophylactic antibiotics for a short period of time were set as Group A, whereas Group B included 731 patients treated with prophylactic antibiotics for experience-based length of time. All the patients' records, including personal information, preoperational medical records, surgical records, postoperative medical information and the development of surgical site infections, were collected for analysis.
RESULTS: In Group A, 153 patients were treated by second generation cephalosporins and 81 patients were treated by clindamycin. The duration of treatment was 1.17 ± 0.38 days. In Group B, 41 patients were treated by penicillin, 375 and 2 patients were treated by second and third generation cephalosporins, respectively, 128 patients were treated by clindamycin, 42 patients were treated by cephamycin, 128 patients were treated by quinolone, other antibiotic was used by 1 patient and other 14 patients were treated by combinations of antibiotics. The duration of the treatment in Group B was 5.72 ± 1.63 days. The significant differences between the length of treatment time in Group A and B were observed (P < 0.001). There were no statistical differences of pre-/post-operational leukocytes number compared between Group A and B. In addition, although the neutrophils in Group A and B are 70.70% ± 9.71% and 67.09% ± 9.78% respectively, indicating a subtle difference (t = 2.921, P = 0.004), however, these numbers were in normal range; therefore, no clinical significance was found from the comparison of neutrophils in groups. A total of 7 cases (0.73%) of surgical site infection were recorded, including 4 cases (1.71%) in Group A and 3 cases (0.41%) in Group B, all of which were posterior laminoplasty. With Fisher analysis (P = 0.063), these infection rates were not statistically significant.
CONCLUSIONS: An appropriate usage of prophylactic antibiotics in a short period of time in cervical spinal surgery did not increase the rate of surgical site infection.