title: Powder Topical Rifampin for Reducing Infections After Neural Tube Defect Surgery in Infants.
abstract: OBJECTIVE
  The correct timing and technique of neural tube defect (NTD) repairs significantly decrease the morbidity and mortality of NTD cases. However, infections related to the surgery are still common. We investigated the effects of topical rifampin combined with routine prophylaxis in newborns with open NTDs.
  
  
  METHODS
  This retrospective study included 86 patients who had undergone NTD surgery. The experimental group comprised 30 patients who were started on topical rifampin before surgery, and the control group comprised 56 patients who were not administered topical rifampin. Surgical site infections (SSIs) and meningitis/ventriculoperitoneal (VP) shunt infections that developed within 6 months after the surgical intervention were evaluated.
  
  
  RESULTS
  In the postoperative period, meningitis/VP shunt infections and SSIs were observed in 6.7% and 3.3%, respectively, of the experimental group treated with topical rifampin. Meningitis/VP shunt infections and SSIs were observed in 37.5% and 21.4%, respectively, of the control group. External ventricular drainage and not using topical rifampin were identified as important relative risk (RR) factors for meningitis/VP shunt infections (RR 19.28, 95% confidence interval [CI] [3.53, 105.33], P = 0.001; RR 18.10, 95% CI [2.38, 137.68], P = 0.005). A flap transposition, cerebrospinal fluid leaks, and not using topical rifampin were identified as RR factors for SSIs (RR 22.21, 95% CI [4.81, 102.47], P < 0.001; RR 13.04, 95% CI [1.22, 139.33], P = 0.034; RR 7.09, 95% CI [1.12, 53.99], P = 0.042). We did not observe any local or systemic side effects resulting from the use of rifampin.
  
  
  CONCLUSIONS
  The use of topical rifampin is an easy and effective method for reducing SSIs and meningitis/VP shunt infections related to NTD surgery.
authors: Division of Neonatology, Department of Pediatrics, Yuzuncu Yil University Medical School, Van, Turkey. Electronic address: demirnihat27@hotmail.com.
authors: Nihat
authors: N
authors: Demir
authors: Division of Neonatology, Department of Pediatrics, Yuzuncu Yil University Medical School, Van, Turkey.
authors: Erdal
authors: E
authors: Peker
authors: Department of Neurosurgery, Yuzuncu Yil University Medical School, Van, Turkey.
authors: İsmail
authors: İ
authors: Gülşen
authors: Department of Pediatrics, Yuzuncu Yil University Medical School, Van, Turkey.
authors: Selami
authors: S
authors: Kocaman
authors: Division of Neonatology, Department of Pediatrics, Yuzuncu Yil University Medical School, Van, Turkey.
authors: Oğuz
authors: O
authors: Tuncer
authors: Division of Neonatology, Department of Pediatrics, Lokman Hekim Hospital, Van, Turkey.
authors: Ercan
authors: E
authors: Kırımi
mesh_terms: D000287:Administration, Topical; D019072:Antibiotic Prophylaxis / Q000379:methods*; D000904:Antibiotics, Antitubercular / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009436:Neural Tube Defects / Q000175:diagnosis* / Q000601:surgery*; D011208:Powders; D012189:Retrospective Studies; D012293:Rifampin / Q000008:administration & dosage*; D013530:Surgical Wound Infection / Q000175:diagnosis* / Q000188:drug therapy*
chemical_list: D000904:Antibiotics, Antitubercular; D011208:Powders; D012293:Rifampin
keywords: Infection; Neural tube defects; Newborn; Topical rifampin