Intra-operative drug level monitoring of pre-operative antibiotic for surgical prophylaxis in the patients of elective spinal surgery

Salim Sheikh; Kumar Swapnil; Chakra Dhar Tripathi; Girish Gulab Meshram; Bushra Ahmed Karim

doi:10.1515/jbcpp-2023-0104

Artikel

Intra-operative drug level monitoring of pre-operative antibiotic for surgical prophylaxis in the patients of elective spinal surgery

Salim Sheikh , Kumar Swapnil , Chakra Dhar Tripathi , Girish Gulab Meshram und Bushra Ahmed Karim

Veröffentlicht/Copyright: 11. September 2023

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Aus der Zeitschrift Journal of Basic and Clinical Physiology and Pharmacology Band 34 Heft 6

Abstract

Objectives

Single dose prophylaxis is good enough for general surgery with low risk patients. However, the evidence for the effectiveness of single dose anti-microbial prophylaxis (AMP) is not conclusive in high risk patients and spinal surgeries requiring instrumentation or the use of implants in particular. No studies have explored the various concentration of ceftriaxone in plasma and tissue as well during an ongoing spinal surgery. Therefore, the objective of study was to correlate the serum and tissue concentrations of ceftriaxone with the SSI and identify patients with increased risk of SSI.

Methods

It was an open label prospective study in 50 consecutive patients who underwent elective spine surgery under prophylactic cover of ceftriaxone. Serum and tissue concentration were estimated by high pressure liquid chromatography during the ongoing surgery.

Results

Subjects were observed for any post-operative complications including SSI. Serum (p=0.002) and tissue (p=0.012) concentrations of ceftriaxone at the closure of spinal surgery were associated with SSI. Duration of the surgery (p=0.04) and use of implants (p=0.02) were also important surgery related risk factors.

Conclusions

Serum and tissue concentrations of ceftriaxone at the closure and duration of surgery and instrumentation or use of implants in the spinal surgery are good predictors of SSI.

Keywords: spine surgery; antibiotic prophylaxis; surgical site infection; ceftriaxone

Corresponding Author: Bushra Ahmed Karim, Associate Professor, Department of Public Health Dentistry, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India, E-mail: bushrakarim786@gmail.com

Research ethics: Our study conformed to the Helsinki Declaration of 1975, revised in 2013. The ethical code followed was the Indian Council of Medical Research (ICMR) National Ethical Guidelines for Biomedical Research on human participants 2017.
Informed consent: A written informed consent was obtained from each of the included patients or their legally acceptable representatives.
Author contributions: Salim Sheikh: Visualization, Data curation, Investigation, Methodology, Software, Writing – original draft. Kumar Swapnil: Data curation, Investigation. Chakra Dhar Tripathi: Conceptualization, Supervision, Validation, Resources, Project Administration. Girish Gulab Meshram: Writing – review & editing. Bushra Ahmed Karim: Formal analysis, Software, Writing – review & editing.
Competing interests: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The data is not available due to ethical restrictions.

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Received: 2023-04-20

Accepted: 2023-08-21

Published Online: 2023-09-11

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Artikel in diesem Heft

https://doi.org/10.1515/jbcpp-2023-0104

Schlagwörter für diesen Artikel

spine surgery; antibiotic prophylaxis; surgical site infection; ceftriaxone