title: Appropriateness of Twenty-four-Hour Antibiotic Prophylaxis After Spinal Surgery in Which a Drain Is Utilized: A Prospective Randomized Study.
abstract: BACKGROUND
  Wound drains that are left in place for a prolonged period of time have a higher rate of bacterial contamination. Following spinal surgery, a drain is often left in place for a longer period of time if it maintains a high output. Given the major consequences of an infection following spinal surgery and the lack of data with regard to the use of antibiotics and drains, we performed a study of patients with a drain following spinal surgery to compare infection rates between those who were treated with antibiotics for twenty-four hours and those who received antibiotics for the duration for which the drain was in place.
  
  
  METHODS
  We performed a prospective randomized trial of 314 patients who underwent multilevel thoracolumbar spinal surgery followed by use of a postoperative drain. The patients were randomized into two groups, one of which received perioperative antibiotics for twenty-four hours (twenty-four-hour group) and the other of which received antibiotics for the duration that the drain was in place (drain-duration group). Data collected included demographic characteristics, medical comorbidities, type of spinal surgery, and surgical site infection.
  
  
  RESULTS
  Twenty-one (12.4%) of the 170 patients in the twenty-four-hour group and nineteen (13.2%) of the 144 in the drain-duration group developed a surgical site infection (p = 0.48). There were no significant differences between the twenty-four-hour and drain-duration groups with respect to demographic characteristics (except for the American Society of Anesthesiologists [ASA] classification), operative time, type of surgery, drain output, or length of hospital stay.
  
  
  CONCLUSIONS
  Continuing perioperative administration of antibiotics for the entire duration that a drain is in place after spinal surgery did not decrease the rate of surgical site infections.
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Richelle C
authors.initials: RC
authors.lastname: Takemoto
authors.affiliation: Mount Sinai Beth Israel, 820 Second Avenue, Suite 7A, New York, NY 10017. E-mail address: blonner@nyc.rr.com.
authors.forename: Baron
authors.initials: B
authors.lastname: Lonner
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Tate
authors.initials: T
authors.lastname: Andres
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Justin
authors.initials: J
authors.lastname: Park
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Pedro
authors.initials: P
authors.lastname: Ricart-Hoffiz
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: John
authors.initials: J
authors.lastname: Bendo
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Goldstein
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Spivak
authors.affiliation: New York University Hospital for Joint Diseases, 301 East 17th Street, New York, NY 10003.
authors.forename: Thomas
authors.initials: T
authors.lastname: Errico
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019072:Antibiotic Prophylaxis / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013131:Spine / Q000601:surgery*; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013997:Time Factors; D055815:Young Adult