医学
开颅术
预防性抗生素
优势比
抗生素
入射(几何)
氯嘧啶
外科
人口
麻醉
内科学
物理
环境卫生
光学
微生物学
生物
青霉素
作者
A.M. Korinek,J.-L. Golmard,A Elcheick,Régis Bismuth,R. Van Effenterre,Pierre Coriat,Louis Puybasset
标识
DOI:10.1080/02688690500145639
摘要
The objective of this study was to evaluate incidence and risk factors of postoperative infections, with emphasis on antibiotic prophylaxis, in a series of 4578 craniotomies. A prospective database was implemented for surveillance of postcraniotomy infections. During period A, no antibiotic prophylaxis was prescribed for scheduled, clean craniotomies, lasting less than 4 h, whereas emergency, clean-contaminated or long-lasting craniotomies received cloxacillin or amoxicillin-clavulanate. During period B, prophylaxis was given to every craniotomy. The effect of prophylaxis on craniotomy infections, independently of other risk factors, was studied by multivariate analysis. The overall infection rate was 6.6%. CSF leak, male gender, surgical diagnosis, surgeon, early re-operation, surgical duration and absence of prophylaxis were independent risk factors. CSF leak had the highest odds ratio. Antibiotic prophylaxis decreased infection rate from 9.7% down to 5.8% in the entire population (p < 0.0001) mainly by decreasing rates in low risk patients from 10.0% down to 4.6% (p < 0.0001). Antibiotic prophylaxis in craniotomy is effective in preventing surgical site infections even in low-risk patients.
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