Faculty Collaboration Database

Antibiotic Prophylaxis and Spinal Infection After Gunshot Wounds to the Spine: A Retrospective Study. J Surg Res 2024 Dec;304:1-8

Date

10/30/2024

Pubmed ID

39471768

DOI

10.1016/j.jss.2024.09.083

Scopus ID

2-s2.0-85207371023 (requires institutional sign-in at Scopus site)

Abstract

INTRODUCTION: Spinal and paraspinal infections (SPIs) are a potential complication following traumatic spinal column injury, and we sought to determine the association of antibiotic prophylaxis on SPI development following a spinal gunshot wound (GSW).

METHODS: A single-center retrospective cohort study was performed on adults who sustained a GSW to the spinal column over 11 y. Patients were excluded if they died within 24 h or had a mechanism other than GSW. Antibiotic use and injury patterns were analyzed.

RESULTS: A total of 330 patients were included in analysis. Most were male (88%), Black (79%), and averaged 27 y old. Mortality was 4%. Prophylactic antibiotics were administered in 65%; and median duration was 5 d. Nine patients (2.7%) developed SPI. Hollow viscus injury (HVIs) (66.7% versus 23.1%, P < 0.001), primarily colon injuries (55.6% versus 12.5%, P < 0.001), were independently associated with SPI. Antibiotic use was not associated with a decrease in SPI (3% versus 2%; P = 0.41). Of the patients who developed SPI, seven received 3 d of antibiotics or less, and this was not statistically significant (P = 0.49).

CONCLUSIONS: Patients with HVIs have a higher incidence of SPI, following spinal GSW. Although antibiotic use and duration did not have a statistically significant association with SPI, no patient, even with HVIs, who received 4 or more days of antibiotics developed an infection. Due to the low incidence of SPI, a multicenter trial may help determine the optimal duration of prophylactic antibiotics. However, we recommend a maximum of 4 d of antibiotics for SPI prophylaxis following GSW.

Author List

Gellings JA, Haberman K, Al Tannir AH, Carver T, Peschman J

Authors

Thomas W. Carver MD Professor in the Surgery department at Medical College of Wisconsin
Jacob R. Peschman MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Anti-Bacterial Agents
Antibiotic Prophylaxis
Female
Humans
Male
Middle Aged
Retrospective Studies
Spinal Injuries
Wounds, Gunshot
Young Adult