Postoperative Oral Antibiotic Use and Infection-Related Complications After Spinal Cord Stimulator Surgery.

Autor: Goel V; Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA. Electronic address: doc.vasudha@gmail.com., Kaizer A; Center for Innovative Design & Analysis, Department of Biostatistics & Informatics, Colorado School of Public Health, Aurora, CO, USA., Patwardhan AM; Department of Anesthesiology, University of Arizona, Tucson, AZ, USA., Ibrahim M; Department of Anesthesiology, University of Arizona, Tucson, AZ, USA., DeSimone DC; Division of Infectious Diseases, Department of Medicine, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA., Sivanesan E; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD, USA., Shankar H; Department of Anesthesiology, Clement J. Zablocki VA Medical Center, Medical College of Wisconsin, Milwaukee, WI, USA.
Jazyk: angličtina
Zdroj: Neuromodulation : journal of the International Neuromodulation Society [Neuromodulation] 2022 Jul; Vol. 25 (5), pp. 738-744. Date of Electronic Publication: 2021 Dec 18.
DOI: 10.1016/j.neurom.2021.10.012
Abstrakt: Objectives: Spinal cord stimulation (SCS) is considered a minimally invasive and reversible neuromodulation therapy for various chronic pain disorders. The rates of infection following SCS surgery reported in the literature range from 2.8% to 10%. Several studies indicated no potential benefit of postoperative antibiotics (beyond 24 hours) on subsequent device infection. This study aimed to understand the characteristics of postoperative antibiotic prescriptions and subsequent infections following SCS surgery.
Materials and Methods: The study was a retrospective cohort using the IBM® MarketScan® Commercial and Medicare Supplemental Databases from 2013 to 2018. Adult patients undergoing SCS surgical procedures with at least 90 days of follow-up were identified using Current Procedural Terminology (CPT®) codes. Postprocedural oral antibiotics within 14 days and preprocedural corticosteroid use within seven days were identified using National Drug Codes (NDC). Administrative claims were analyzed to understand the characteristics of prescribed postoperative antibiotics. Infection-related complications within 90 days were identified using administrative codes.
Results: A total of 18,105 patients (age 55.5 ± 13.1 years, 40.2% male) underwent SCS surgery during the study period. Postprocedural oral antibiotics and preprocedural steroids were prescribed for 35.3% and 2.6%, respectively, for SCS surgery patients. The most commonly used postprocedural antibiotics were cephalexin (55.4%) and sulfamethoxazole-trimethoprim (10.6%). The most common duration of antibiotic prescriptions was seven, ten, and five days in our study, from most to least common duration. Superficial surgical site infection (SSI), deep SSI, device infection, or any infection within 90 days occurred in 2.9%, 1.0%, 1.8%, and 4%, respectively, of the patients undergoing SCS surgery.
Conclusions: Prospective studies are needed to understand the reasons for noncompliance with expert consensus recommendations on postoperative antibiotic use beyond 24 hours of SCS surgery. Neuromodulation team members should play an important role in antibiotic stewardship.
(Copyright © 2021 International Neuromodulation Society. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: