Is implant washing and wound irrigation with rifampicin effective for preventing surgical site infections in lumbar instrumentation?

Karaarslan, Numan; Yılmaz, İbrahim; Özbek, Hanefí; Öznam, Kadir; Ateş, Özkan; Erdem, Ilknur

doi:10.5137/1019-5149.jtn.21341-17.2

Cited by 6 publications

(9 citation statements)

References 16 publications

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“…Antibiotic resistance has become an important health problem It is known that the ability of different antibiotics to penetrate bone may also vary (12). Fluoroquinolones, clindamycin, rifampicin, fusidic acid, and metronidazole have good levels of penetration into bone tissue.…”

Section: █ Discussionmentioning

confidence: 99%

Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Doğan

Şimşek²,

Yılmaz³

et al. 2019

Turkish Neurosurgery

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AIM: To investigate the efficacy of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis (PVO) cases. MATERIAL and METHODS: The records of patients with culture-negative PVO who were treated at infectious disease and neurosurgery outpatient clinics in the past four years were examined retrospectively. The control group comprised healthy subjects with similar age, gender, and body mass index but without pathology. In the statistical evaluation of the obtained data, the comparison of the groups was performed by analysis of variance. Statistical significance was accepted as p<0.05. RESULTS: No statistically significant difference in the white blood cell count and erythrocyte sedimentation rate was found between the spondylodiscitis and the healthy subject groups when the blood parameters obtained before and after the treatment (p>0.05). However, a statistical significance was assessed in the results of the comparison for C-reactive protein (p<0.05). CONCLUSION: In the context of evidence-based medicine and the rational use of antibiotics, it is clear that antibiotics should be preferred according to the culture antibiogram results in the treatment of infectious diseases.

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Section: █ Discussionmentioning

confidence: 99%

Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Doğan

Şimşek²,

Yılmaz³

et al. 2019

Turkish Neurosurgery

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“…In cases such as septic arthritis, osteomyelitis, and spondylodiscitis, antibiotics can be used in long-term, high, and repeated doses (7,22,25,38). In addition to their side effect profile, antibiotics used in this way may also have adverse effects that cause toxicity, particularly during surgery, to avoid such negativities (9,10,17,22,25,27,31). RQ = 0.9, respectively.…”

Section: █ Discussionmentioning

confidence: 99%

“…There are also reports in the literature that suggest treatment using local rather than systemic application yields more effective results against infections that form a biofilm layer (40). However, studies reporting that the pre-and/or intraoperative irrigation of instruments with antibiotics may not be effective in preventing infection are also found in the literature (22).…”

Section: Necati Kaplanmentioning

confidence: 99%

“…Both positive (7,25,29,38), and negative (3, 22,25,26,34) effects are referred by studies in the literature regarding DAP. However, there are no pharmaco-molecular studies of highevidential value that evaluate the efficacy of DAP on healthy and intact intervertebral disc tissue cells in the literature.…”

Section: Necati Kaplanmentioning

confidence: 99%

“…Cultures were maintained by replacing the medium every two days. DAP was added to perform experiments on the cell cultures that became confluent and adhered to the floor at the end of the overnight incubation period (18, [20][21][22]24), and 350 mg of DAP (Cubicin ® 350 mg) was dissolved in 7 ml of 0.9% NaCl. Thus, a stock solution with a concentration of 50 mg/ ml DAP was prepared.…”

Section: Preparation Of Primary Cell Cultures and Dap Addition To Thementioning

confidence: 99%

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Evaluation of the effect of daptomycin, a glycopeptide agent, on intact intervertebral disc tissue

Kaplan¹,

Yılmaz²,

Karaarslan³

et al. 2018

Turkish Neurosurgery

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AIM: To evaluate the effects of pre-and intra-operatively administered daptomycin (DAP) on the intact human primary intervertebral disc tissue cells. MATERIAL and METHODS: Primary cell cultures were established using tissues obtained through decompressive laminectomy, traumatic intervertebral disc herniation excision, and posterior transpedicular stabilization. Non-drug-administered samples were used as a control group. The samples treated with DAP formed the study group. Molecular assays for proliferation and gene expression were performed. The obtained data were evaluated statistically, and results with a value of p<0.05 were accepted as significant. RESULTS: While no reduction was observed in the proliferation, the gene expression of intact intervertebral disc tissue cells was time-dependently decreased compared to the control group, and these results were reported to be statistically significant. CONCLUSION: This study observed the effect that a pharmaceutical preparation, which was used on intervertebral disc tissue before and after the operation, had on normal, healthy, and intact tissue. It concludes that alterations in the expression of genes involved in the anabolic and/or catabolic process, even in adjacent healthy tissue, may slow down the healing process of the damaged tissue or cause undesired cell differentiation.

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The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study

Zanotti¹,

Muggiolu²,

Maria

2023

Annals of Medicine &Amp; Surgery

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Study Design: Retrospective cohort study. Objective: The authors’ goal was to clarify whether a bone substitute combined with antibiotics might gain a hold in spinal surgery as a preventive treatment for early infections (EIs). Background: A relatively infrequent but severe complication in spinal surgery is the occurrence of EIs. Methods: The authors retrospectively compared a population undergoing posterolateral fusion with Mg-enriched hydroxyapatite paste mixed with 60 mg rifampicin powder, with a matched population treated with autologous bone without antibiotics. A total of 30 patients from 2020 to 2021 were included in our study. We estimated EI’s relative risk and the number needed to treat. Statistical analyses were performed using the R statistical package v3.4.1 (http://www.r-project.org). Results: No early infections occurred in the population treated with antibiotic-combined bone substitutes, compared with 6.7% of patients treated with autologous bone without antibiotics. The relative risk of EIs was 0.33 (P=.49; 95% CI=0.01–7.58) and the number needed to treat was 15. Conclusions: The results support the hypothesis that combining bone substitutes with antibiotics may decrease the risk of EIs and could be a viable option to improve spinal surgery outcomes. However, a larger sample size would be needed to confirm the benefit of rifampicin-combined Mg-enriched hydroxyapatite substitutes over autologous bone for surgical site infection prevention. Level of Evidence: Level 3.

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Is implant washing and wound irrigation with rifampicin effective for preventing surgical site infections in lumbar instrumentation?

Cited by 6 publications

References 16 publications

Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Evaluation of empirical antibiotic treatment in culture-negative pyogenic vertebral osteomyelitis

Evaluation of the effect of daptomycin, a glycopeptide agent, on intact intervertebral disc tissue

The benefit of antibiotic-combined Mg-hydroxyapatite bone graft substitute over autologous bone for surgical site infection prevention in posterolateral spinal fusion: a retrospective cohort study

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