(611) Intraoperative Topical Antibiotics and Postoperative Infection Rates

Introduction: Current guidelines do not recommend the use of antibiotic irrigations due to lack of data on benefit. Despite guidance against its use, topical antibiotics are still administered in the operative setting. The goal of this retrospective evaluation was to compare infection rates between surgical procedures that utilized topical antibiotics and those that did not.

Methods: A retrospective analysis of operative topical antibiotic use from July 1, 2023, and December 31, 2023 was performed. Data collected included whether the procedure had a National Healthcare Safety Network (NHSN) reportable infection, antibiotics utilized, administration methods, procedure performed, and services utilizing the antibiotics (e.g., orthopedics, neurosurgery).

Results: Of 32,185 procedures, 1,327 utilized topical antibiotics (4.12%) with a total of 1,807 topical antibiotic administrations. Eighty-four of the 32,185 procedures had NHSN-reported infections (0.26%). Patients not receiving intra-operative topical antibiotics had a post-operative infection rate of 0.24% compared to 0.83% of those receiving topical antibiotics (p < 0.05).

Conclusions: Intra-operative topical antibiotics are still being used despite guideline recommendations. There is risk involved in this practice, including non-sterile compounding occurring in the operating room as these antibiotics bypass pharmacist safety checks. This study supports current guideline recommendations that intra-operative topical antibiotics do not reduce post-operative infections.