Single-dose Antibiotic Prophylaxis in Regional Anesthesia A Retrospective Registry Analysis

被引:23
作者
Bomberg, Hagen [1 ]
Krotten, Denise [1 ]
Kubulus, Christine [1 ]
Wagenpfeil, Stefan [2 ]
Kessler, Paul [3 ]
Steinfeldt, Thorsten [4 ]
Standl, Thomas [5 ]
Gottschalk, Andre [6 ]
Stork, Jan [7 ]
Meissner, Winfried [8 ]
Birnbaum, Juergen [9 ,10 ]
Koch, Thea [11 ]
Sessler, Daniel I. [12 ]
Volk, Thomas [1 ]
Raddatz, Alexander [1 ]
机构
[1] Univ Saarland, Univ Med Ctr, Dept Anaesthesiol Intens Care Med & Pain Med, Homburg, Germany
[2] Univ Saarland, Univ Med Ctr, Inst Med Biometry Epidemiol & Med Informat, Homburg, Germany
[3] Orthopaed Univ Hosp, Dept Anaesthesiol Intens Care & Pain Med, Frankfurt, Germany
[4] Univ Marburg, Dept Anaesthesiol & Intens Care Therapy, Marburg, Germany
[5] Acad Hosp Solingen, Dept Anaesthesia Intens & Palliat Care Med, Solingen, Germany
[6] Friederikenstift, Dept Anaesthesiol Intens Care & Pain Med, Hannover, Germany
[7] Univ Med Ctr Hamburg Eppendorf, Ctr Anaesthesiol & Intens Care Med, Hamburg, Germany
[8] Jena Univ Hosp, Dept Anaesthesiol & Intens Care, Jena, Thuringia, Germany
[9] Charite, Dept Anaesthesiol & Operat Intens Care Med, Charite Campus Virchow Klinikum, Berlin, Germany
[10] Charite, Campus Mitte, Berlin, Germany
[11] Tech Univ Dresden, Dept Anesthesiol & Crit Care Med, Univ Hosp Carl Gustav Carus, Dresden, Germany
[12] Cleveland Clin, Dept Outcomes Res, Inst Anesthesiol, Cleveland, OH 44106 USA
关键词
RISK-FACTOR; COMPLICATIONS; SURGERY; CATHETERS; ANALGESIA; QUALITY; OBESITY; BLOCK;
D O I
10.1097/ALN.0000000000001218
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: 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. Methods: 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). Results: 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). Conclusions: Single-dose antibiotic prophylaxis was associated with fewer peripheral and epidural catheter infections.
引用
收藏
页码:505 / 515
页数:11
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