Home E-Weekly May 30, 2017

Will Administering Antibiotics 'Late' Reduce Your SSIs?

Published: May 30, 2017

TIME CHANGE Each patient received an IV infusion of cefuroxime either "early," in the anesthesia room, or "late," in the OR. The SSI rate was 4.9% in the early group, and 5.3% in the late group.

Will narrowing the window for administering pre-operative antibiotics decrease the likelihood of a patient developing a surgical site infection? Not according to a newly published study conducted by Swiss researchers.

A randomized trial of general surgery adult inpatients at 2 Swiss hospitals attempted to determine the precise optimum timing administration of surgical antimicrobial prophylaxis. Whether the antibiotics were given at about 60 minutes before surgery or at less than 30 minutes, the hospitals showed almost no difference in overall SSIs.

Between Feb. 21, 2013, and Aug. 3, 2015, 5,580 patients received pre-operative antibiotic treatment — specifically, a 1.5g intravenous infusion of cefuroxime (combined with 500mg of metronidazole in colorectal surgery) — either "early," in the anesthesia room, or "late," in the OR. Of those, 5,175 patients were analyzed: 2,589 in the early group; and 2,586 in the late group. The median administration time was 42 minutes before incision in the early group and 16 minutes before incision in the late group.

The overall SSI rate was 5.1% (234 of 4,596) — 4.9% in the early group, and 5.3% in the late group — and the length-of-stay duration and 30-day mortality rates were also similar between the 2 groups. The follow-up rate was 100% (5,175 of 5,175 patients), and the outpatient 30-day follow-up rate was 88.8% (4,596 of 5,175).

Bill Donahue

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