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Cefuroxime prophylaxis is effective in noninstrumented spine surgery: a double-blind, placebo-controlled study

Petignat, Christiane
Francioli, Patrick
Regli, Luca
Porchet, François
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Published in Spine. 2008, vol. 33, no. 18, p. 1919-24
Abstract STUDY DESIGN: 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. SUMMARY OF BACKGROUND DATA: 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. CONCLUSION: A single, preoperative dose of cefuroxime significantly reduces the risk of organ-space infection, most notably spondylodiscitis, after surgery for herniated disc.
Keywords AdolescentAdultAgedAged, 80 and overAntibiotic Prophylaxis/methodsCefuroxime/administration & dosageDouble-Blind MethodFemaleHumansIntervertebral Disk Displacement/drug therapy/surgeryMaleMiddle AgedNeurosurgical Procedures/adverse effects/methodsSurgical Wound Infection/prevention & control
PMID: 18708923
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Research groups Epidémiologie et contrôle de la résistance aux antibiotiques (866)
Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière (330)
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PETIGNAT, Christiane et al. Cefuroxime prophylaxis is effective in noninstrumented spine surgery: a double-blind, placebo-controlled study. In: Spine, 2008, vol. 33, n° 18, p. 1919-24. doi: 10.1097/BRS.0b013e31817d97cf https://archive-ouverte.unige.ch/unige:1708

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Deposited on : 2009-05-25

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