title: Retrospective analysis of a new antibiotic chemoprophylaxis regimen in 170 patients undergoing endoscopic endonasal transsphenoidal surgery.
abstract: BACKGROUND
  The aim of this study is to evaluate the rate of infectious complications post endoscopic transspheinodal neurosurgery in patients receiving a new antibiotic chemoprophylaxis regimen.
  
  
  METHODS
  Clinical records of 170 patients who received prophylaxis with a third-generation cephalosporin plus aminoglycoside (160 cases) or alone (10 cases) were retrospectively analyzed. Twenty-eight patients (16.4%) had CSF leakage. The postsurgical follow-up ranged from 3 months to 4 years.
  
  
  RESULTS
  Of 170 patients, 2 (1.17%) developed infectious complications: 1 case of meningitis by Staphylococcus epidermidis and 1 case of sphenoid sinusitis (without microbiological diagnosis). In addition, asymptomatic sphenoid sinusitis was diagnosed in 2 other patients. The cost ranged from 22.50 to 33.34 euros/d.
  
  
  CONCLUSIONS
  The rate of infectious complications was very low in patients receiving prophylaxis with a third-generation cephalosporin plus aminoglycoside or alone; because of the broad-spectrum of antibiotics and their high cost, this regimen could be used in at-risk patients (eg, smokers, patients with cerebrospinal leak, or patients with Cushing diseases).
authors.affiliation: Department of Public Medicine and Social Security, Section of Infectious Diseases, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Napoli, Italy. raffaele.orlando@unina.it
authors.forename: Raffaele
authors.initials: R
authors.lastname: Orlando
authors.forename: Paolo
authors.initials: P
authors.lastname: Cappabianca
authors.forename: Grazia
authors.initials: G
authors.lastname: Tosone
authors.forename: Felice
authors.initials: F
authors.lastname: Esposito
authors.forename: Marcello
authors.initials: M
authors.lastname: Piazza
authors.forename: Enrico
authors.initials: E
authors.lastname: de Divitiis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000583:Amikacin / Q000008:administration & dosage* / Q000191:economics; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000191:economics; D019072:Antibiotic Prophylaxis / Q000191:economics / Q000379:methods*; D002442:Ceftazidime / Q000008:administration & dosage* / Q000191:economics; D002443:Ceftriaxone / Q000008:administration & dosage* / Q000191:economics; D003362:Cost-Benefit Analysis; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004724:Endoscopy / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000209:etiology / Q000517:prevention & control*
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D000583:Amikacin; D002442:Ceftazidime