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

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.

• Authors: K L Holloway, K W Smith, J E Wilberger Jr, J G Jemsek, G C Giguere, J J Collins
• Journal: Clinical therapeutics (Clin Ther) 1996 Jan-Feb Vol. 18 Issue 1 Pg. 84-94 ISSN: 0149-2918 [Print] United States
• PMID: 8851455 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)

Chemical References

• Cephalosporins
• Cefuroxime

Topics

• Adult
• Antibiotic Prophylaxis
• Cefuroxime (therapeutic use)
• Cephalosporins (therapeutic use)
• Female
• Humans
• Male
• Middle Aged
• Neurosurgery (methods)
• Surgical Wound Infection (prevention & control)
• United States