title: Long-term intravenous administration of antibiotics for lumbar spinal surgery prolongs the duration of hospital stay and time to normalize body temperature after surgery.
abstract: METHODS
  Comparative study of differing durations of antibiotics for spinal surgery.
  
  
  OBJECTIVE
  To compare rate of infection, duration of hospital stay, days until normal body temperature, and a panel of blood tests after surgery between long-term and short-term administration of antibiotics for spinal surgery using instrumentation.
  
  
  BACKGROUND
  Recent studies have reported that long-term administration of intravenous antibiotics is not necessary to avoid superficial and deep infections. We therefore changed the duration of administration from 9 to 2 days in our lumbar surgery patients.
  
  
  METHODS
  We examined 135 patients (average age, 64.9 years) who underwent lumbar spinal surgery to insert a pedicle screw system to treat spinal canal stenosis. We administered 2 g of cefotiam daily to 60 patients for 9 days after surgery and to 75 patients for 2 days after surgery. Surgical time, loss of blood, rate of infection, duration of hospital stay, days until normal body temperature, and data from blood analysis (white blood cell count, and C-reactive protein [CRP] level) were statistically compared between the 2 groups.
  
  
  RESULTS
  No significant differences in intraoperative measures of surgical invasion were observed between the 2 groups (surgical time, 209 vs. 220 minutes; blood loss, 530 vs. 576 mL; blood transfusion, 344 vs. 380 mL for the long-term and short-term groups, respectively). No acute infections occurred in either group. However, the duration of hospital stay (20.7 days), time until normal body temperature (5.1 days), and CRP level (2.23 mg/dL) at day 7 after surgery were significantly less in the short-term group than those in the long-term group (27.9 days, 6.8 days, and 3.13 mg/dL, respectively; P < 0.05).
  
  
  CONCLUSIONS
  These results indicate that short-term intravenous administration of antibiotics did not elevate the infection rate after spinal surgery using instrumentation. However, long-term administration of antibiotics prolonged the duration of hospital stay, inhibited normalization of body temperature, and elevated CRP levels. Long-term administration of antibiotics may suppress normal, beneficial bacteria, thereby having an adverse effect on patient recovery.
authors.affiliation: Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chuo-ku, Chiba, Japan. sohtori@faculty.chiba-u.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Ohtori
authors.forename: Gen
authors.initials: G
authors.lastname: Inoue
authors.forename: Takana
authors.initials: T
authors.lastname: Koshi
authors.forename: Masaomi
authors.initials: M
authors.lastname: Yamashita
authors.forename: Kazuyo
authors.initials: K
authors.lastname: Yamauchi
authors.forename: Munetaka
authors.initials: M
authors.lastname: Suzuki
authors.forename: Sumihisa
authors.initials: S
authors.lastname: Orita
authors.forename: Yawara
authors.initials: Y
authors.lastname: Eguchi
authors.forename: Nobuyasu
authors.initials: N
authors.lastname: Ochiai
authors.forename: Shunji
authors.initials: S
authors.lastname: Kishida
authors.forename: Masashi
authors.initials: M
authors.lastname: Takaso
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Takahashi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001831:Body Temperature / Q000187:drug effects* / Q000502:physiology; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007902:Length of Stay; D008159:Lumbar Vertebrae / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000503:physiopathology; D013122:Spinal Diseases / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D013995:Time; D013997:Time Factors
chemical_list: D000900:Anti-Bacterial Agents