Short-duration, single-agent antibiotic prophylaxis for XXXX in trans-sphenoidal surgery.

@entity1 @entity2261 @entity1244 @entity4008 @entity75 @entity5898 @entity693 @entity293
Perioperative @entity4008 after trans-sphenoidal surgery for pituitary and @entity75 is an uncommon but serious complication. Little evidence guides the choice of chemoprophylaxis in this setting. To begin to address this deficiency, we investigated the incidence of perioperative @entity693 in 442 @entity1 who underwent trans-sphenoidal surgery and received a short chemoprophylaxis regimen with a single agent and did not require lumbar drainage. In 2005 we instituted a standardized antibiotic prophylaxis protocol for trans-sphenoidal surgery that utilized intravenous @entity2261 , a second-generation @entity5898 with broad coverage and excellent spinal fluid penetration, administered 30 min before surgery and 8 h later. The primary endpoint was the incidence of perioperative (within 30 days of surgery) @entity4008 . Data from The Barrow Pituitary Outcomes Project, a prospectively maintained @entity1 research database, were supplemented with review of medical records and hospital discharge codes. There were no cases of perioperative @entity693 . Three @entity1 developed delayed @entity693 associated with persistent or recurrent spinal fluid leakage 2-8 months after surgery. Perioperatively, seven @entity1 received additional antibiotics for @entity293 . A single-agent, short-duration chemoprophylaxis regimen for trans-sphenoidal surgery is effective at preventing perioperative @entity693 in @entity1 who do not require lumbar drainage after surgery. The results of this regimen compare favorably to historical rates achieved with longer regimens that use two antibiotics. Future studies will investigate the role prophylactic antibiotics play in nasal mucosa healing and @entity1244 .
