Postoperative Oral Antibiotic Use and Infection-Related Complications After Spinal Cord Stimulator Surgery

2022 ◽  
Author(s):  
Vasudha Goel ◽  
Alexander Kaizer ◽  
Amol M. Patwardhan ◽  
Mohab Ibrahim ◽  
Daniel C. DeSimone ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Antibiotic Use ◽  
Oral Antibiotic ◽  
Spinal Cord Stimulator

scholarly journals 144. Little evidence of same-day, oral antibiotic prescribing at ambulatory surgery centers

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S82-S83
Author(s):  
Laura M King ◽  
Lauri Hicks ◽  
Sarah Kabbani; Sharon Tsay ◽  
Katherine E Fleming-Dutra
Keyword(s):  
Surgical Procedures ◽  
Ambulatory Surgery ◽  
Antibiotic Use ◽  
Antibiotic Prescribing ◽  
Oral Antibiotic ◽  
Chi Square ◽  
Convenience Sample ◽  
Ambulatory Surgery Centers ◽  
National Public Health ◽  
Course Length

Abstract Background The objective of our study was to describe oral antibiotic prescriptions associated with procedures in ambulatory surgery centers (ASC) to evaluate if there are major national opportunities to improve antibiotic use in this setting. Methods We identified surgical procedures in ASCs and oral antibiotic prescriptions in the IBM® MarketScan® Commercial 2018 database, a large convenience sample of privately-insured individuals aged < 65 years. We excluded visits with same-day hospitalizations and those with infectious diagnoses that may warrant antibiotic treatment. We included only antibiotic prescriptions dispensed on the same day as an ASC visit. We calculated the number of visits and oral antibiotic prescriptions and the percent of visits with oral antibiotic prescriptions overall, and by patient age group (< 18 and 18–64 years), antibiotic class, and procedure type. We also calculated median antibiotic course length. Across-group comparisons were evaluated using chi-square tests. Results In 2018, 918,127 ASC visits with surgical procedure codes were captured, of which 37,032 (4.0%) were associated with same-day oral antibiotic prescriptions. The percent of visits with antibiotic prescriptions was significantly higher among children compared to adults (9.4% vs 3.8%; p< 0.01); however, adults accounted for 89% of prescriptions. Respiratory/nasal and urinary tract system procedures were most frequently associated with antibiotic prescriptions (Figure). Median course length was 5 (interquartile range 3–7) days. The most common antibiotic class was cephalosporins (49.6% of prescriptions), followed by penicillins (12.6%) and fluoroquinolones (10.9%). Figure. Percent of ambulatory surgery center visits with same-day antibiotic prescriptions by procedure category, IBM® MarketScan® Commercial Database, 2018 Conclusion Only 4% of ASC procedures were associated with same-day oral antibiotic prescriptions, suggesting antibiotics are not commonly prescribed in ASCs on the day of surgical procedures. Additionally, the observed 5-day median duration may suggest that some of these courses are intended for treatment rather than prophylaxis. Our estimates represent lower bounds for oral antibiotic prescriptions in this setting, as we only captured same-day prescriptions. However, our findings suggest that ASC facilities may not be high-impact targets for national, public health antibiotic stewardship efforts. Disclosures All Authors: No reported disclosures

scholarly journals Improving intravenous-to-oral antibiotic switch in children: a team-based audit and implementation approach

2021 ◽  
Vol 10 (1) ◽  
pp. e001120
Author(s):  
Brendan Joseph McMullan ◽  
Michelle Mahony ◽  
Lolita Java ◽  
Mona Mostaghim ◽  
Michael Plaister ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Antibiotic Use ◽  
Hospital Length ◽  
Audit And Feedback ◽  
Hospital Length Of Stay ◽  
Oral Antibiotic ◽  
Intravenous Therapy ◽  
Paediatric Hospital ◽  
Inpatient Settings ◽  
Surgical Teams

Children in hospital are frequently prescribed intravenous antibiotics for longer than needed. Programmes to optimise timely intravenous-to-oral antibiotic switch may limit excessive in-hospital antibiotic use, minimise complications of intravenous therapy and allow children to go home faster. Here, we describe a quality improvement approach to implement a guideline, with team-based education, audit and feedback, for timely, safe switch from intravenous-to-oral antibiotics in hospitalised children. Eligibility for switch was based on evidence-based guidelines and supported by education and feedback. The project was conducted over 12 months in a tertiary paediatric hospital. Primary outcomes assessed were the proportion of eligible children admitted under paediatric and surgical teams switched within 24 hours, and switch timing prior to and after guideline launch. Secondary outcomes were hospital length of stay, recommencement of intravenous therapy or readmission. The percentage of children switched within 24 hours of eligibility significantly increased from 32/50 (64%) at baseline to 203/249 (82%) post-implementation (p=0.006). The median time to switch fell from 15 hours 42 min to 4 hours 20 min (p=0.0006). In addition, there was a 14-hour median reduction in hospital length of stay (p=0.008). Readmission to hospital and recommencement of intravenous therapy did not significantly change postimplementation. This education, audit and feedback approach improved timely intravenous-to-oral switch in children and also allowed for more timely discharge from hospital. The study demonstrates proof of concept for this implementation with a methodology that can be readily adapted to other paediatric inpatient settings.

Neurophysiological Monitoring During Spinal Cord Stimulator Placement Surgery

2015 ◽  
Vol 18 (6) ◽  
pp. 460-464 ◽  
Author(s):  
Arvydas A. Tamkus ◽  
Andrew F. Scott ◽  
Fahd R. Khan
Keyword(s):  
Spinal Cord ◽  
Neurophysiological Monitoring ◽  
Spinal Cord Stimulator

Epidural Lipomatosis as a Cause for High Impedance Values During a Spinal Cord Stimulator Trial

PM&R ◽  
2013 ◽  
Vol 5 (8) ◽  
pp. 729-731 ◽  
Author(s):  
Carolyn F. Schulz ◽  
Timothy T. Davis ◽  
Daniel A. Fung
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulator ◽  
Epidural Lipomatosis ◽  
High Impedance

scholarly journals The design of an embedded spinal cord stimulator

2014 ◽  
Vol 22 ◽  
pp. 1453-1462 ◽  
Author(s):  
Fikret YALÇINKAYA ◽  
Ali ERBAŞ
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulator

Successful management of pain syndrome due to Angiostrongylus cantonensis by implantable spinal cord stimulator

1999 ◽  
Vol 29 (4) ◽  
pp. 565-565 ◽  
Author(s):  
J. A. CRUMP ◽  
S. T. CHAMBERS ◽  
R. H. ACLAND ◽  
M. R. McKINNEY ◽  
D. R. MURDOCH ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Pain Syndrome ◽  
Angiostrongylus Cantonensis ◽  
Spinal Cord Stimulator ◽  
Successful Management
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