Simple peroperative antimicrobial chemoprophylaxis in elective neurosurgical operations.
From August 1981 to February 1982 postoperative infections due to different strains of penicillin-resistant Staphylococcus aureus occurred in 20 of 467 patients (4.3%) undergoing elective cranial and spinal operations. These infections were not attributable to defects in procedures or the theatre environment, therefore chemoprophylaxis was instituted. In the following 8 months, when patients were given penicillin G and sulphadiazine for 5 days commencing immediately postoperatively, S. aureus infections occurred in five of 579 patients (0.9%). In a subsequent randomized uncontrolled study, infections occurred in six of 265 patients receiving penicillin (2.3%), three of 270 receiving penicillin and sulphadiazine (1.1%) and one of 45 receiving erythromycin (2.2%) immediately postoperatively for 5 days. In a further study in which 587 patients received penicillin for 5 days commencing immediately preoperatively, infections due to S. aureus occurred in six (1.1%). Infections due to gram-negative organisms were seen in five (0.4%) of 1167 patients in the two uncontrolled studies.
Ingham
H R
HR
Department of Microbiology, Newcastle General Hospital.
Kalbag
R M
RM
Sisson
P R
PR
Allcutt
D A
DA
Betty
M J
MJ
Crawford
P J
PJ
Gillham
N R
NR
Hankinson
J
J
Sengupta
R P
RP
Strong
A J
AJ
D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009493:Neurosurgery; D010400:Penicillin G / Q000008:administration & dosage*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D011897:Random Allocation; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013411:Sulfadiazine / Q000008:administration & dosage*; D013530:Surgical Wound Infection / Q000517:prevention & control*
D013411:Sulfadiazine; D010400:Penicillin G