April 25, 2019

Increased duration of surgical antimicrobial prophylaxis linked to adverse events

By: Judy Mathias

Editor’s Note

In this multi-center study, longer durations of surgical prophylaxis did not result in further reductions in surgical site infections (SSIs) but were associated with increasing adverse events.

Of 79,058 surgical patients in the VA healthcare system, SSI was not associated with duration of prophylaxis, but odds of acute kidney injury increased with each additional day of prophylaxis. The risk of postoperative Clostridium difficile infection had a similar duration-dependent association. Receiving vancomycin was also a significant risk factor for acute kidney injury.

These findings highlight the point that every day and every dose matters and suggest that efforts to limit the duration of prophylaxis have the potential to reduce adverse events without increasing SSIs, the authors note.

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