The efficacy of antibiotic prophylaxis in dean and scheduled craniotomy: a retrospective study

CAO Yiyao; PU Ke; LI Guodong; SUN Zhiming; LI Qingguo

Abstract：Objective The effect of antibiotic prophylaxis (AP) on the rate of post-operative infection in craniotomy was discussed and the risk factors for the infection were studied.Methods The clean and scheduled craniotomy cases which had undergone surgery in the 8th Department of Neurosurgery in Tianjin Huanhu Hospital during 6 years were collected.For the cases treated from January 2009 to November 2011,antibiotic prophylaxis was prescribed for all surgeries.For cases from November 2011 to December 2014,no antibiotic prophylaxis (n-AP) was administered to all patients.The infection rate of two groups after surgery was analyzed.Additionally,independent risk factors for infection were investigated using Logistic regression analysis.Results A total of 579 cases were enrolled in the study including 250 cases with 23 infection cases in AP group,and 329 cases with 30 infection cases in n-AP group.There was no statistically significant difference between two groups in infection rate (x2 =0.01,P=0.973).The positive rates of bacterial culture were 27.3％ in the AP group compared to 59.3％ in the n-AP group.The rate did differ significantly between two groups (x2 =5.01,P =0.025).CSF leakage (OR:38.4,95％CI:10.03 ～ 146.58) and surgery time (OR:1.12,95％ CI:1.01 ～ 1.25) were the independent risk factors for postoperative infection in the Logistic regression model.Conclusion Antibiotic prophylaxis can not reduce the rate of post-operative infection in clean and scheduled craniotomy.Additionally,AP appears to reduce the positive rate of bacterial culture.The independent risk factors for post-operative infection are CSF leakage and surgery time.