Korinek et al reviewed the impact of prophylactic antibiotic therapy for a patient undergoing craniotomy. The authors are from the University of Paris VI.
Patient selection: craniotomy
Prevalence of surgical site infection without prophylaxis: 8-10%
Prevalence of surgical site infection with prophylaxis: 4-6%
Prevalence of postoperative meningitis: 1.5%
Risk factors for surgical site infection:
(1) CSF leak
(2) male gender
(3) surgical diagnosis
(4) surgeon
(5) early reoperation
(6) surgical duration (> 4 hours)
(7) absence of antibiotic prophylaxis
(8) emergency surgery
Antibiotic prophylaxis did not prevent postoperative meningitis. It also selected for noncutaneous organisms resistant to the antibiotics used for prophylaxis. Infection by noncutaneous organisms was associated with a higher mortality.
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