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Neurosurgical Standards Cerebral Aneurysms Malignant Gliomas pp 387–392Cite as

Intraoperative Antibiotic Prophylaxis in Neurosurgery: A Prospective Randomized Trial in 840 Patients

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Part of the book series: Advances in Neurosurgery ((NEURO,volume 20))

Summary

The efficacy of a single dose of cefotiam as prophylaxis for postoperative infection was analyzed in a prospective randomized study of 840 patients undergoing either carniotomy (group I, n = 711) or cerebrospinal fluid shunting (group II, n = 129). The main interest was centered on the rate of bone flap infection and shunt sepsis requiring operative revision. Data were evaluated in the total groups and various subgroups formed for high risk patients. Our results show a highly significant difference for postoperative bone flap infection, with 0.3% in the cefotiam group versus 5.1% in the control group (p < 0.001). The overall rate of postoperative deep wound infections including meningitis and abscess (group I) was also significantly different (3.1% vs 9.0%, p < 0.005). This was also true for wound infections in high risk patients (3.1% vs 10.6%) as well as for postoperative sepsis and pneumonia. The overall rate of shunt infections (group II) was 7.5% in the cefotiam group and 12.9% in the control group, with the differences not being statistically significant either for the main group or for high risk subgroups. In summary, antibiotic prophylaxis has proven to be effective for prevention of postoperative infection in patients undergoing craniotomy. Although our results in shunt patients do not reach statistical significance, we also recommend single dose prophylaxis in these cases, since there is a clear difference of infection rate between patients receiving and not receiving the antibiotic.

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Author information

Authors and Affiliations

  1. Neurochirurgische Universitätsklinik, Sigmund-Freud-Str. 25, W-5300, Bonn 1, Germany

    J. Zentner

  2. Neurochirurgische Klinik der RWTH, Pauwelstr. 30, W-5100, Aachen, Germany

    J. Gilsbach

  3. Neurochirurgische Universitätsklinik, Hugstetter Str. 55, W-7800, Freiburg, Germany

    T. Gaillard

Authors
  1. J. Zentner
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  2. J. Gilsbach
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  3. T. Gaillard
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Editor information

Editors and Affiliations

  1. Neurochirurgische Klinik, Zentralkrankenhaus, St.-Jürgen-Str., W-2800, Bremen 1, Germany

    Kurt Piscol

  2. Neurochirurgische Klinik der Universität Erlangen-Nürnberg, Schwabachanlage 6 (Kopfklinikum), W-8520, Erlangen, Germany

    Margareta Klinger

  3. Neurochirurgische Klinik und Poliklinik, Universitätsklinikum Steglitz, Freie Universität Berlin, Hindenburgdamm 30, W-1000, Berlin 45, Germany

    Mario Brock

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© 1992 Springer-Verlag Berlin Heidelberg

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Zentner, J., Gilsbach, J., Gaillard, T. (1992). Intraoperative Antibiotic Prophylaxis in Neurosurgery: A Prospective Randomized Trial in 840 Patients. In: Piscol, K., Klinger, M., Brock, M. (eds) Neurosurgical Standards Cerebral Aneurysms Malignant Gliomas. Advances in Neurosurgery, vol 20. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-77109-5_68

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  • DOI: https://doi.org/10.1007/978-3-642-77109-5_68

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-54838-6

  • Online ISBN: 978-3-642-77109-5

  • eBook Packages: Springer Book Archive

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