Cefuroxime prophylaxis is effective in noninstrumented spine surgery: a double-blind, placebo-controlled study.
METHODS
Double-blind, placebo-controlled randomized clinical trial.


OBJECTIVE
To assess the efficacy of 1 preoperative 1.5 g dose of cefuroxime in preventing surgical site infection after surgery for herniated disc.


BACKGROUND
Antibiotic prophylaxis was only tested in nonconclusive trials in this setting.


METHODS
The study was conducted in 2 university hospitals in Switzerland. Patients were assessed for occurrence of surgical site infection (defined by the criteria of the Centers for Diseases Control and Prevention), other infections, or adverse events up to 6 months after surgery. Outcome measures were compared in a univariate, per-protocol analysis.


RESULTS
Baseline characteristics were similar in patients allocated to cefuroxime (n = 613) or placebo (n = 624). Eight (1.3%) patients in the cefuroxime group and 18 patients (2.8%) in the placebo group developed a surgical site infection (P = 0.073). A diagnosis of spondylodiscitis or epidural abscess was made in 9 patients in the placebo group, but none in the cefuroxime group (P < 0.01), which corresponded to a number necessary to treat of 69 patients to prevent one of these infections. There were no significant adverse events attributed to either cefuroxime or placebo.


CONCLUSIONS
A single, preoperative dose of cefuroxime significantly reduces the risk of organ-space infection, most notably spondylodiscitis, after surgery for herniated disc.
Petignat
Christiane
C
Service of Hospital Preventive Medicine, Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland.
Francioli
Patrick
P
Harbarth
Stephan
S
Regli
Luca
L
Porchet
François
F
Reverdin
Alain
A
Rilliet
Benedict
B
de Tribolet
Nicolas
N
Pannatier
André
A
Pittet
Didier
D
Zanetti
Giorgio
G
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002444:Cefuroxime / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000188:drug therapy / Q000601:surgery; D008297:Male; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods*; D013530:Surgical Wound Infection / Q000517:prevention & control
D002444:Cefuroxime