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PubMed · 8851455

Antibiotic prophylaxis during clean neurosurgery: a large, multicenter study using cefuroxime.

K L Holloway·K W Smith·J E Wilberger·J G Jemsek·G C Giguere·J J Collins
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Abstract

Cefuroxime is a second-generation cephalosporin with in vitro activity against the organisms that are commonly associated with neurosurgical wound infections. Other properties of cefuroxime are an elimination half-life of 1.3 hours, which yields prolonged serum concentrations, and its ability to penetrate the blood-brain barrier in proportion to the degree of inflammation. A prospective, multicenter, open-label study was conducted to evaluate the efficacy and safety of cefuroxime for antibiotic prophylaxis in patients undergoing clean neurosurgery. Cefuroxime 1.5 g was given intravenously 25 to 60 minutes before surgery; for procedures lasting more than 3 hours, cefuroxime 750 mg was given intravenously 8 hours after the initial dose. Patients were examined before surgery, daily during hospitalization, and at 8 weeks after surgery. A total of 956 adults were enrolled in the study. The most common procedures in study patients were laminectomy (41.8% of patients) or craniotomy (24.3%), and the mean duration of surgery was 3.2 hours. Infection occurred in 2 (0.3%) of 592 assessable patients by the time of discharge and in 1 additional patient by the 8-week follow-up evaluation for a total of 3 (0.5%) of 560 assessable patients. Drug-related adverse events occurred in 5 (0.5%) of 956 patients. These results indicate that antibiotic prophylaxis with cefuroxime is associated with a low incidence of postoperative wound infection and is well tolerated in patients undergoing clean neurosurgery.

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AdultAntibiotic ProphylaxisCefuroximeCephalosporinsFemaleHumansMaleMiddle AgedNeurosurgerySurgical Wound InfectionUnited StatesClinical TrialComparative StudyJournal ArticleMulticenter StudyResearch Support, Non-U.S. Gov't

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K L Holloway, K W Smith, J E Wilberger, J G Jemsek, G C Giguere, J J Collins. Antibiotic prophylaxis during clean neurosurgery: a large, multicenter study using cefuroxime.. https://doi.org/10.1016/s0149-2918(96)80181-0

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