title: Antimicrobial prophylaxis at the neurosurgical department of a major hospital in China: compare of cross-sectional studies.
abstract: OBJECTIVE
  To compare the effects of post neurosurgical antimicrobial prophylaxis before and after the adoption of a new protocol in our department, which changed from prolonged prophylaxis to limited usage.
  
  
  METHODS
  Two cross-sectional studies were performed to compare the 24-hour antimicrobial use for all the inpatients at the neurosurgical ward 1 day before (June 30, 2011) and 1 year after (June 29, 2012) the beginning of the new rules. Student's t-test or the chisquare test were used to compare baseline characteristics and prophylactic or therapeutic antimicrobial usage between the groups.
  
  
  RESULTS
  The total of 391 patients enrolled consisted of 221 for June 30, 2011 as group 1 and 170 for June 29, 2012 as group 2. The baseline characteristics of the groups showed no significant difference. The prophylactic use significantly decreased in Group 2 (13.1% vs. 5.9%, p=0.018). However, total therapeutic use (10.9% vs. 18.2%, p=0.041) and the use for nosocomial infection (7.32% vs. 15.9%, p=0.009) both increased significantly in Group 2. Furthermore, therapeutic use for surgical site infections also increased significantly (3.16% vs. 9.41%, p=0.015).
  
  
  CONCLUSIONS
  Shorter antimicrobial prophylaxis may increase post neurosurgical infection. The optimal duration of neurosurgical antimicrobial prophylaxis should be compliant with local hospital conditions and further prospective trials are required to address this issue on a procedure-specific basis.
authors.affiliation: Sichuan University, West China Hospital, Department of Neurosurgery, Chengdu Sichuan, China.
authors.forename: Cong
authors.initials: C
authors.lastname: Wu
authors.forename: Chaohua
authors.initials: C
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: He
authors.forename: Chao
authors.initials: C
authors.lastname: You
mesh_terms: D000328:Adult; D000890:Anti-Infective Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000706:statistics & numerical data*; D002681:China / Q000453:epidemiology; D003428:Cross Infection / Q000453:epidemiology / Q000517:prevention & control; D003430:Cross-Sectional Studies; D004334:Drug Administration Schedule; D004632:Emergency Medical Services / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000706:statistics & numerical data*; D017063:Outcome Assessment, Health Care; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000890:Anti-Infective Agents