title: Single-dose Antibiotic Prophylaxis in Regional Anesthesia: A Retrospective Registry Analysis.
abstract: Catheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections.
  
  
  
  Our analysis was based on cases in the 25-center German Network for Regional Anesthesia database recorded between 2007 and 2014. Forty thousand three hundred sixty-two surgical patients who had continuous regional anesthesia were grouped into no antibiotic prophylaxis (n = 15,965) and single-dose antibiotic prophylaxis (n = 24,397). Catheter-related infections in each group were compared with chi-square test after 1:1 propensity-score matching. Odds ratios (ORs [95% CI]) were calculated with logistic regression and adjusted for imbalanced variables (standardized difference more than 0.1).
  
  
  
  Propensity matching successfully paired 11,307 patients with single-dose antibiotic prophylaxis (46% of 24,397 patients) and with 11,307 controls (71% of 15,965 patients). For peripheral catheters, the incidence without antibiotics (2.4%) was greater than with antibiotic prophylaxis (1.1%, P < 0.001; adjusted OR, 2.02; 95% CI, 1.49 to 2.75, P < 0.001). Infections of epidural catheters were also more common without antibiotics (5.2%) than with antibiotics (3.1%, P < 0.001; adjusted OR, 1.94; 95% CI, 1.55 to 2.43, P < 0.001).
  
  
  
  Single-dose antibiotic prophylaxis was associated with fewer peripheral and epidural catheter infections.
authors.affiliation: From the Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University, University Medical Centre, Homburg/Saar, Germany (H.B., D.K., C.K., T.V., A.R.); Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, University Medical Centre, Homburg/Saar, Germany (S.W.); Department of Anaesthesiology, Intensive Care and Pain Medicine, Orthopaedic University Hospital, Frankfurt, Germany (P.K.); Department of Anaesthesiology and Intensive Care Therapy, Philipps University Marburg, Marburg, Germany (T. Steinfeldt); Department of Anaesthesia, Intensive and Palliative Care Medicine, Academic Hospital Solingen, Solingen, Germany (T. Standl); Department of Anaesthesiology, Intensive Care and Pain Medicine, Friederikenstift, Hannover, Germany (A.G.); Centre for Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (J.S.); Department of Anaesthesiology and Intensive Care, Jena University Hospital, Jena, Thuringia, Germany (W.M.); Department of Anaesthesiology and Operative Intensive Care Medicine, Charité Campus Virchow Klinikum and Campus Mitte, Charité University Medicine Berlin, Berlin, Germany (J.B.); Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (T.K.); and Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio (D.I.S.).
authors.forename: Hagen
authors.initials: H
authors.lastname: Bomberg
authors.forename: Denise
authors.initials: D
authors.lastname: Krotten
authors.forename: Christine
authors.initials: C
authors.lastname: Kubulus
authors.forename: Stefan
authors.initials: S
authors.lastname: Wagenpfeil
authors.forename: Paul
authors.initials: P
authors.lastname: Kessler
authors.forename: Thorsten
authors.initials: T
authors.lastname: Steinfeldt
authors.forename: Thomas
authors.initials: T
authors.lastname: Standl
authors.forename: André
authors.initials: A
authors.lastname: Gottschalk
authors.forename: Jan
authors.initials: J
authors.lastname: Stork
authors.forename: Winfried
authors.initials: W
authors.lastname: Meissner
authors.forename: Juergen
authors.initials: J
authors.lastname: Birnbaum
authors.forename: Thea
authors.initials: T
authors.lastname: Koch
authors.forename: Daniel I
authors.initials: DI
authors.lastname: Sessler
authors.forename: Thomas
authors.initials: T
authors.lastname: Volk
authors.forename: Alexander
authors.initials: A
authors.lastname: Raddatz
mesh_terms: D000293:Adolescent; D000765:Anesthesia, Conduction / Q000009:adverse effects*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D055499:Catheter-Related Infections / Q000209:etiology / Q000517:prevention & control*; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D012042:Registries / Q000706:statistics & numerical data*; D012189:Retrospective Studies