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Novel outpatient treatment strategy for cranial infections – a single-center experience [Abstract]
(2023)
Oral e-Poster Presentations - Booth 1: Trends & Innovation A, September 26, 2023, 1:00 PM - 2:30 PM
Background: Antibiotic therapy of cranial infections is a resource-intensive process. On the background of the recommendation for longer-term antibiotic administration for cranial infections, we established an outpatient intravenous antibiotic administration in our hospital.
Methods: The aim of this study was to evaluate the usefulness of outpatient antibiotic therapy in cranial neurosurgery. For this purpose, we included all patients who received a peripherally inserted central catheter (PICC line) for intravenous antibiotic therapy for cranial infections between 01/20 and 9/22. We evaluated the available patient data with regard to the infectiological and neurosurgical issues. All patients received intravenous antibiotics for at least 6 weeks (inpatient and outpatient).
Results: In total, we were able to include 30 patients. The median age was 58.12 years (SD +/- 13.39 years). The proportion of female patients was 43%. The mean hospital stay was 18.4 days (SD +/- 4.97 days) for total inpatient treatment. Subsequent mean outpatient antibiotic therapy was admitted for 71.7 days (SD +/- 23.18 days). Outpatient mean IV therapy accounted for 53.88 days (SD +/- 18.56 days). The most common pathogens were Staphylococcus epidermis and cutibacteria. In 9%, microbiological samples were. In all patients, neither radiographic nor laboratory evidence of inflammation was found in the final control. During outpatient intravenous therapy, 12% of patients experienced a difficult patency of the PICC line due to the prolonged administration of antibiotics. This could be corrected radiologically in each case. In addition, one patient, independent of therapy, showed structural epilepsy after the abscess healing.
Conclusions: Outpatient IV antibiotic therapy via a PICC line catheter is a safe and feasible method for long-term antibiotic treatment of cranial infections.
Prolonged antibiotic therapy is often recommended for the treatment of spinal infections. This study aimed to evaluate the efficacy and safety of outpatient intravenous (IV) antibiotic therapy for spinal neurosurgery patients with spondylodiscitis. We carried out a retrospective study involving 67 patients who were administered peripherally inserted central catheter (PICC) for IV antibiotic treatment from January 2020 to December 2022. We assessed patient data concerning infections and neurosurgical concerns. Each patient underwent a minimum of 6 weeks of IV antibiotics, both as inpatients and outpatients. The study included 67 patients with a median age of 61 years (SD +/- 14.18 years), with approximately 44% being female. The average hospital stay for inpatient treatment was 20 days (SD +/- 8.8 days). Subsequent outpatient antibiotic therapy lasted an average of 70.32 days (SD +/- 18.24 days), with outpatient IV therapy accounting for 44.74 days (SD +/- 9.15 days). The most common pathogens identified were Staphylococcus epidermidis and methicillin-sensitive Staphylococcus aureus. Microbiological analysis did not detect any pathogens in 18% of patients. Radiographic and laboratory evidence of spondylodiscitis was absent in 99% of patients during the final follow-up. No catheter-related complications occurred. Outpatient IV antibiotic therapy using a PICC line catheter is a safe and effective treatment option for spinal infections, especially in elderly patients.
