Antimicrobial Prophylaxis of Transsphenoidal Pituitary Resections

Abstract Title: Antimicrobial Prophylaxis of Transsphenoidal Pituitary Resections Authors: Victoria Sansom, Pharm.D. Candidate; Craig A. Martin, Pharm.D., BCPS; Aaron M. Cook, PharmD., BCPS Background: Endoscopic transsphenoidal surgery (ETS) is an emerging technique used in the removal of tumors from the pituitary gland and sellar region of the skull. Several risk factors for infection in ETS have been acknowledged in the literature, such as implantation of nasal splints and surgery in an area naturally contaminated with bacteria (the sinus). Antimicrobial prophylaxis is commonly used in patients undergoing ETS. While the importance of appropriate antimicrobial prophylaxis is acknowledged in the literature, there are no guidelines that specify the ideal antibiotic regimen. Extended prophylaxis is also commonly used after ETS, but is somewhat lacking in support. Objectives: Primary Objective: 1. To characterize antibiotic prophylaxis in patients undergoing ETS. a. Describe the population that receives antibiotic prophylaxis for ETS b. Identify antibiotic regimens used prophylactically for ETS c. Identify duration of prophylactic antibiotic use for ETS. Secondary Objectives: 1. To identify risk factors for the development of infectious complications in 30 days following ETS. 2. To describe the rate for infectious complications in 30 days following ETS Methods: Retrospective electronic medical chart review of adult inpatients who underwent ETS January 1, 2009 - December 31, 2010. Patient demographics included age, gender, weight, indication for surgery, and current disease states presenting risk for infection. Descriptive statistics and Chi Square test were used in the statistical analysis. Results: Results will be analyzed and presented. Preliminary results suggest no significant difference in infection and readmission rates in patients who received extended antibiotic prophylaxis versus patients who did not. There is also no association between post-operative corticosteroids and infection rate. Post-operative infection was rare and no adverse effects from outpatient antimicrobial were noted. Conclusion: To be determined pending results.