Abstract | BACKGROUND AND PURPOSE: METHODS: This is a randomized, controlled study of antibiotic prophylaxis in patients with ischemic stroke enrolled within 24 hours from clinical onset who presented bedridden (modified Rankin score >3) with no significant infection. Interventions included prophylactic mezlocillin plus sulbactam (3 x 2 g/1 g for 4 days) or conventional management. Over 10 days, body temperature was continuously monitored, and the presence of infection was daily assessed. Primary end points were incidence and height of fever; secondary end points included rate of infection and clinical outcome. RESULTS: Sixty patients were included (mean, 75 years; median National Institutes of Health Stroke Scale score, 16). Over the first 3 days, patients in the intervention group showed lower mean body temperatures as well as lower daily peak temperatures (P<0.05). Throughout the observation period, 15 of 30 patients in the intervention group but 27 of 30 patients in the conventionally treated group developed an infection (P<0.05). Mean interval until the diagnosis of infection was 5.1 days in the intervention group and 3.3 days in the control group (P<0.05). Clinical outcome was more favorable in patients with prophylactic therapy (P=0.01). CONCLUSIONS: In patients with acute severe stroke, prophylactic administration of mezlocillin plus sulbactam over 4 days decreases body temperature, lowers the rate of infection, and may be associated with a better clinical outcome.
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Authors | Stefan Schwarz, Frank Al-Shajlawi, Christian Sick, Stephen Meairs, Michael G Hennerici |
Journal | Stroke
(Stroke)
Vol. 39
Issue 4
Pg. 1220-7
(Apr 2008)
ISSN: 1524-4628 [Electronic] United States |
PMID | 18309164
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Anti-Bacterial Agents
- Mezlocillin
- Sulbactam
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Topics |
- Acute Disease
- Aged
- Aged, 80 and over
- Anti-Bacterial Agents
(administration & dosage)
- Bacterial Infections
(epidemiology, prevention & control)
- Brain Ischemia
(drug therapy, epidemiology)
- Drug Therapy, Combination
- Female
- Fever
(epidemiology, prevention & control)
- Humans
- Incidence
- Male
- Mezlocillin
(administration & dosage)
- Middle Aged
- Pilot Projects
- Prognosis
- Severity of Illness Index
- Stroke
(drug therapy, epidemiology)
- Sulbactam
(administration & dosage)
- Treatment Outcome
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