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

Anesthesiology. 2016 Sep;125(3):505-15. doi: 10.1097/ALN.0000000000001218.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anesthesia, Conduction / adverse effects*
  • Antibiotic Prophylaxis / statistics & numerical data*
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / prevention & control*
  • Female
  • Germany
  • Humans
  • Male
  • Registries / statistics & numerical data*
  • Retrospective Studies