Results of a randomized trial of vancomycin prophylaxis in craniotomy.
A single prophylactic dose of vancomycin was given in 143 supratentorial craniotomies with a bone flap and 26 suboccipital craniotomies. No antimicrobial agents were given to two similar groups of patients: 172 with supratentorial craniotomy and 19 with suboccipital craniotomy. The infection rate in the vancomycin groups was significantly lower (p less than 0.013), and bone-flap infections alone, the most common infection after supratentorial craniotomy, were significantly fewer (p less than 0.042). Antimicrobial prophylaxis is recommended only for selected high-risk groups. Since a bone flap is devascularized, its resistance to infection is reduced and, once infected, it usually requires surgical removal. Patients undergoing craniotomy with a bone flap therefore form a high-risk group, and antimicrobial prophylaxis is justified.
Blomstedt
G C
GC
Department of Neurosurgery, Helsinki University Central Hospital, Finland.
Kyttä
J
J
D000328:Adult; D002986:Clinical Trials as Topic; D003399:Craniotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011897:Random Allocation; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014640:Vancomycin / Q000009:adverse effects / Q000627:therapeutic use*
D014640:Vancomycin