ArticleInfection control and hospital epidemiology2022
Association between duration of antimicrobial prophylaxis and postoperative outcomes after lumbar spine surgery.
Article in Infection control and hospital epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Shorter Versus Prolonged Systemic Perioperative Antibiotic Prophylaxis in Clean Orthopedic Surgery: A Systematic Review and Meta-Analysis.Antibiotics (Basel, Switzerland) · 2026Review
- Early Discontinuation of Prophylactic Antibiotics Is Not Associated with Increased Surgical Site Infection Risk in Spine Surgery: A Nationwide Cohort Study.Antibiotics (Basel, Switzerland) · 2026Article
- Incidence and Risk Assessment of Acute Kidney Injury (AKI) in Spine Surgery: A Case Report and Literature Review.Journal of clinical medicine · 2025Review
- Surgical and procedural antibiotic prophylaxis in the surgical ICU: an American Association for the Surgery of Trauma Critical Care Committee clinical consensus document.Trauma surgery & acute care open · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesTo describe the association between duration of antimicrobial prophylaxis (AMP) and 30-day surgical site infection (SSI), 7-day acute kidney injury (AKI), 90-day
designSurvey. PARTICIPANTS AND
settingThe study cohort comprised 6,198 patients who underwent lumbar spine surgery for noninfectious indications across 137 Veterans' Health Administration surgery centers between 2016 and 2020.
methodsUsed univariate and multivariate logistic regression to determine the association between type and duration of AMP with 30-day SSI, 7-day AKI, 90-day CDI, prolonged hospitalization, and 30-day reoperation.
resultsOnly 1,160 participants (18.7%) received the recommended duration of AMP. On multivariate analysis, the use of multiple prophylactic antimicrobials was associated with increased odds of 90-day CDI (adjusted odds ratio [aOR], 5.5; 95% confidence interval [CI], 1.1-28.2) and 30-day reoperation (aOR, 2.3; 95% CI, 1.2-4.4). Courses of antimicrobials ≥3 days were associated with increased odds of prolonged hospitalization (aOR,1.8; 95% CI, 1.4-2.3) and 30-day reoperation (aOR, 3.5; 95% CI, 2.2-5.7). In univariate analysis, increasing days of AMP was associated with a trend toward increasing odds of 90-day CDI (cOR, 1.4; 95% CI, 1.0-1.8 per additional day;
conclusionsLonger courses of AMP after lumbar spine surgery were associated with higher odds of CDI, prolonged hospitalization, and reoperation, but not with lower odds of SSI. However, adherence to the recommended duration of AMP is very low, hinting at a wide evidence-to-practice gap that needs to be addressed by spine surgeons and antimicrobial stewardship programs.
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