Postsurgical Infection: Comparative Efficacy of Intravenous Cefoperazone/Sulbactam and Cefazoline in Preventing Surgical Site Infection After Neurosurgery

Object The objective of the investigation was to determine the comparative efficacy of cefoperazone/sulbactam versus cefazoline in the prophylaxis of patients undergoing neurosurgical procedures and to evaluate the choice of appropriate antibiotics for surgical prophylaxis. Methods Consecutive patients undergoing neurosurgery in 2003 were recruited for the study. Patients undergoing neurosurgical procedures were assigned randomly to groups, one receiving cefoperazone/sulbactam, and the other receiving cefazoline for antimicrobial prophylaxis. All patients were followed for a minimum of 2 weeks postoperatively and all surgical site infections (SSIs) were recorded. Results A total of 28 postoperative SSIs were identified from 483 cases, with 13 (5.3%) in the cefoperazone/sulbactam group and 15 (6.4%) in the cefazoline group, with a resulting overall infection rate of 5.8%. The difference between the 2 groups was not statistically significant (P>0.05). The predominantly isolated microorganisms in patients with SSIs were Staphylococcus aureus [21 (75.0%)], Acinetobacter baumanii [4 (14.3%)], and Staphylococcus epidermidis [3 (10.7%)]. Conclusions As no single regimen of prophylactic antibiotic agent is appropriate for all neurosurgical procedures at all hospitals, the expected organisms cultured from prior wound infections should determine the appropriate antimicrobial therapy for each institution.