gms | German Medical Science

72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

06.06. - 09.06.2021

Outpatient antibiotic treatment in neurosurgical patients – a prospective case series

Ambulante parenterale Antibiotika-Therapie (APAT) bei neurochirurgischen Patienten

Meeting Abstract

  • presenting/speaker Vicki Butenschoen - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Kathrin Rothe - Klinikum rechts der Isar, Technical University Munich, Institute for Medical Microbiology, München, Deutschland
  • Christiane Querbach - Klinikum rechts der Isar, Technical University Munich, Krankenhausapotheke, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland
  • Chiara Negwer - Klinikum rechts der Isar, Technische Universität München, Neurochirurgische Klinik und Poliklinik, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 72. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Polnischen Gesellschaft für Neurochirurgie. sine loco [digital], 06.-09.06.2021. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocV253

doi: 10.3205/21dgnc238, urn:nbn:de:0183-21dgnc2382

Veröffentlicht: 4. Juni 2021

© 2021 Butenschoen et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.


Gliederung

Text

Objective: Spondylodiscitis and intracranial as well as spinal empyema present challenging cases in the neurosurgical context, and often require a long-term intravenous antibiotic treatment. In order to prevent independent patients from an extensive hospital stay, intravenous antibiotic treatment can be performed in an outpatient setting. Current literature supports its advantages, but lacks data regarding neurosurgical patients. We hereby aim to provide evidence of potential benefits of outpatient antibiotic treatment in neurosurgical patients.

Methods: We prospectively enrolled all patients eligible for outpatient antibiotic treatment in our neurosurgical department. We assessed inflammation markers, the clinical status using the SF-36 and EQ-5D questionnaires and the length of hospital stay and readmittance.

Results: Over a period of 10 months, we included a total of 12 patients. 5 patients suffered from spinal infections (2 patients with spondylodiscitis, 2 spinal empyema, 1 postoperative infection), 7 patients presented with intracranial infections (5 patients with subdural empyema, 1 patient with intracranial abscess, 1 patient with hypophysitis). In 11/12 patients, we identified specific bacteria causing the inflammation (63.6% Staphylococcus species). Median duration of antibiotic treatment was 8 weeks (4 weeks intravenous followed by 4 weeks oral treatment). Mean length of hospital stay was 16 days (range 5-42 days). 2 complications were detected: 1 patient with adverse reaction due to flucloxacillin (leucopenia) and 1 patient with a thrombosis, none of them affected the overall outcome. Patient were satisfied with the outpatient antibiotic treatment.

Conclusion: Outpatient antibiotic treatment provides a satisfying alternative for independent patients requiring long-term intravenous antibiotics. All neurosurgical patients were successfully treated and described a high contentedness with the outpatient treatment.