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

Publication

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

Journal Paper/Review - Nov 1, 2013

Liu Weiming, Neidert Marian Christoph, Groen Rob J M, Woernle Christoph Michael, Grundmann Hajo

Citation

Liu W, Neidert M, Groen R, Woernle C, Grundmann H. Third-generation cephalosporins as antibiotic prophylaxis in neurosurgery: what's the evidence?. Clin Neurol Neurosurg 2013; 116:13-9.

Type

Journal Paper/Review (English)

Journal

Clin Neurol Neurosurg 2013; 116

Publication Date

Nov 1, 2013

Issn Electronic

1872-6968

Pages

13-9

Brief description/objective

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.