• Hagen Bomberg, Denise Krotten, Christine Kubulus, Stefan Wagenpfeil, Paul Kessler, Thorsten Steinfeldt, Thomas Standl, André Gottschalk, Jan Stork, Winfried Meissner, Juergen Birnbaum, Thea Koch, Daniel I Sessler, Thomas Volk, and Alexander Raddatz.
• From the Department of Anaesthesiology, Intensive Care Medicine and Pain Medicine, Saarland University, University Medical Centre, Homburg/Saar, Germany (H.B., D.K., C.K., T.V., A.R.); Institute for Medical Biometry, Epidemiology and Medical Informatics, Saarland University, University Medical Centre, Homburg/Saar, Germany (S.W.); Department of Anaesthesiology, Intensive Care and Pain Medicine, Orthopaedic University Hospital, Frankfurt, Germany (P.K.); Department of Anaesthesiology and Intensive Care Therapy, Philipps University Marburg, Marburg, Germany (T. Steinfeldt); Department of Anaesthesia, Intensive and Palliative Care Medicine, Academic Hospital Solingen, Solingen, Germany (T. Standl); Department of Anaesthesiology, Intensive Care and Pain Medicine, Friederikenstift, Hannover, Germany (A.G.); Centre for Anaesthesiology and Intensive Care Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany (J.S.); Department of Anaesthesiology and Intensive Care, Jena University Hospital, Jena, Thuringia, Germany (W.M.); Department of Anaesthesiology and Operative Intensive Care Medicine, Charité Campus Virchow Klinikum and Campus Mitte, Charité University Medicine Berlin, Berlin, Germany (J.B.); Department of Anesthesiology and Critical Care Medicine, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany (T.K.); and Department of Outcomes Research, Anesthesiology Institute, Cleveland Clinic, Cleveland, Ohio (D.I.S.).
• Anesthesiology. 2016 Sep 1; 125 (3): 505-15.

BackgroundCatheter-related infection is a serious complication of continuous regional anesthesia. The authors tested the hypothesis that single-dose antibiotic prophylaxis is associated with a lower incidence of catheter-related infections.MethodsOur analysis was based on cases in the 25-center German Network for Regional Anesthesia database recorded between 2007 and 2014. Forty thousand three hundred sixty-two surgical patients who had continuous regional anesthesia were grouped into no antibiotic prophylaxis (n = 15,965) and single-dose antibiotic prophylaxis (n = 24,397). Catheter-related infections in each group were compared with chi-square test after 1:1 propensity-score matching. Odds ratios (ORs [95% CI]) were calculated with logistic regression and adjusted for imbalanced variables (standardized difference more than 0.1).ResultsPropensity matching successfully paired 11,307 patients with single-dose antibiotic prophylaxis (46% of 24,397 patients) and with 11,307 controls (71% of 15,965 patients). For peripheral catheters, the incidence without antibiotics (2.4%) was greater than with antibiotic prophylaxis (1.1%, P < 0.001; adjusted OR, 2.02; 95% CI, 1.49 to 2.75, P < 0.001). Infections of epidural catheters were also more common without antibiotics (5.2%) than with antibiotics (3.1%, P < 0.001; adjusted OR, 1.94; 95% CI, 1.55 to 2.43, P < 0.001).ConclusionsSingle-dose antibiotic prophylaxis was associated with fewer peripheral and epidural catheter infections.

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