Third-generation cephalosporins as antibiotic prophylaxis in neurosurgery: What's the evidence?

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• 作者：Weiming Liu ; Marian Christoph Neidert ; Rob J.M. Groen ; Christoph Michael Woernle ; Hajo Grundmann
• 关键词：Antibiotic prophylaxis ; Neurosurgery ; Meta-analysis ; Surgical site infections ; Third-generation cephalosporins
• 刊名：Clinical Neurology and Neurosurgery
• 出版年：January, 2014
• 年：2014
• 卷：116
• 期：Complete
• 页码：13-19
• 全文大小：1148 K

文摘

To analyze the role of third-generation cephalosporins as prophylactic antibiotics in neurosurgery. We reviewed the literature for data from randomized controlled trials (RCTs) on third-generation cephalosporins compared to other antibiotic regimen in neurosurgery. End point of the RCTs was the occurrence of surgical site infections (SSIs) - data were pooled in a fixed-effects meta-analysis.

Five randomized controlled trials enrolling a total of 2209 patients were identified. The pooled odds ratio for SSIs (overall) with third-generation cephalosporins prophylaxis in the five RCTs was 0.94 (95% CI, 0.59-1.52; P = 0.81). No significant difference between third-generation cephalosporins and alternative regimen was identified. When analyzing organ SSIs (osteomyelitis, meningitis, and others intracranial infections) in data derived from four RCTs (1596 patients), third-generation cephalosporins failed to show superiority (pooled odds ratio 0.88; 95% CI 0.45-1.74; P = 0.72).

Third-generation cephalosporin antibiotic prophylaxis fails to show superiority over conventional regimens regarding both incisional and organ related SSIs in neurosurgery.