Surgical Prophylaxis Duration with a Drain

by Matthew Songin Patient Caseson Posted on

A 52-year-old female who is post-op day 1 s/p lumbar spine surgery has a drain left in place following surgery. Does antimicrobial prophylaxis need to be continued while the drain is in place?

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Best Answer

No

Explanation: Continuing prophylactic antibiotics beyond 24 hours post-operatively when is a drain is present does not reduce surgical site infections and increases harm. In a meta-analysis comprised of 7 studies with a total 2446 patients undergoing spine surgery, no difference in deep surgical site infections occurred between groups that received prolonged prophylactic systemic antibiotics (>24 to 72 hours or duration of drain placement) vs. those who received a short course (≤ 24 hours). Deep surgical site infections occurred in 45/1149 (3.9%) and 46/1297 (3.5%) in the prolonged and short groups, respectively. Rates of superficial and overall surgical site infections were also similar.

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