Topical vancomycin to reduce surgical-site infections in neurosurgery: Study protocol for a multi-center, randomized controlled trial. Academic Article uri icon

Overview

abstract

  • Surgical-site infections (SSIs) account for 20% of all healthcare-associated infections, are the most common nosocomial infection among surgical patients, and are a focus of quality improvement initiatives. Despite implementation of many quality care measures (e.g. prophylactic antibiotics), SSIs remain a significant cause of morbidity, mortality, and economic burden, particularly in the field of neurosurgery. Topical vancomycin is increasingly utilized in instrumented spinal and cardiothoracic procedures, where it has been shown to reduce the risk of SSIs. However, a randomized controlled trial assessing its efficacy in the general neurosurgical population has yet to be done. The principle aim of "Topical Vancomycin for Neurosurgery Wound Prophylaxis" (NCT02284126) is to determine whether prophylactic, topical vancomycin reduces the risk of SSIs in the adult neurosurgical population. This prospective, multicenter, patient-blinded, randomized controlled trial will enroll patients to receive the standard of care plus topical vancomycin, or the standard of care alone. The primary endpoint of this study is a SSI by postoperative day (POD) 30. Patients must be over 18years of age. Patients are excluded for renal insufficiency, vancomycin allergy, and some ineligible procedures. Univariate analysis and logistic regression will determine the effect of topical vancomycin on SSIs at 30days. A randomized controlled trial is needed to determine the efficacy of this treatment. Results of this trial are expected to directly influence the standard of care and prevention of SSIs in neurosurgical patients.

authors

  • Jonokuchi, Alexander J
  • Knopman, Jared
  • Radwanski, Ryan E
  • Martinez, Moises A
  • Taylor, Blake Eaton Samuel
  • Rothbaum, Michael
  • Sullivan, Sean
  • Robison, Trae R
  • Lo, Eric
  • Christophe, Brandon R
  • Bruce, Eliza M
  • Khan, Sabrina
  • Kellner, Christopher P
  • Sigounas, Dimitri
  • Youngerman, Brett
  • Bagiella, Emilia
  • Angevine, Peter D
  • Lowy, Franklin D
  • Sander Connolly, E

publication date

  • October 10, 2017

Research

keywords

  • Anti-Bacterial Agents
  • Antibiotic Prophylaxis
  • Neurosurgical Procedures
  • Surgical Wound Infection
  • Vancomycin

Identity

Scopus Document Identifier

  • 85032391447

Digital Object Identifier (DOI)

  • 10.1016/j.cct.2017.10.004

PubMed ID

  • 29030268

Additional Document Info

volume

  • 64