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Open Access 01-11-2020 | Craniotomy | Original Article - Infection

Preoperative antibiotic prophylaxis regimen in brain tumour surgery in Sweden: a quasi-experimental study

Authors: Simon Skyrman, Jiri Bartek Jr, Maryam Haghighi, Ida Fornebo, Tomas Skoglund, Asgeir Store Jakola, Ann-Christin von Vogelsang, Petter Förander

Published in: Acta Neurochirurgica | Issue 11/2020

Abstract

Background

There has been varied clinical practice concerning antibiotic prophylaxis in patients undergoing craniotomy. In Sweden, both Cloxacillin and Cefuroxime have frequently been used. We aimed to study the clinical effectiveness of these two regimens.

Methods

A quasi-experimental design was used. The sample consisted of 580 adult (> 18 years) patients operated 2012–2015, of which 375 received Cloxacillin (pre-intervention group) and 205 received Cefuroxime (intervention group). Primary endpoint was the incidence of surgical site infection (SSI) 12 months after surgery, while secondary endpoints were the need for reoperation due to SSI, the amount antibiotics used and the number of visits in the outpatient clinic related to SSI. A control group from another institution was reviewed to rule out clinical trial effects.

Results

When analysed by intention to treat, the pre-intervention group had a significant higher incidence of SSI, 13.3% (50/375) vs 5.4% (11/205) in the intervention group (p < 0.01). A treatment per protocol analysis confirmed the result. The number of reoperations due to SSI were significantly reduced in the intervention group, 3.4% (7/205) vs 8.3% (31/375) (p = 0.02), as was the total antibiotic use (p = 0.03) and the number of visits in the outpatient clinic (p < 0.01). In the control group, the reoperation rate as result of SSI was lower (p = 0.02) prior to the opposite change from Cefuroxime to Cloxacillin, 1.8% (27/1529) vs 3.1% (43/1378).

Conclusion

In Sweden, Cefuroxime as prophylaxis in brain tumour surgery by craniotomy seems to be superior to Cloxacillin.

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Title: Preoperative antibiotic prophylaxis regimen in brain tumour surgery in Sweden: a quasi-experimental study
Authors: Simon Skyrman
Jiri Bartek Jr
Maryam Haghighi
Ida Fornebo
Tomas Skoglund
Asgeir Store Jakola
Ann-Christin von Vogelsang
Petter Förander
Publication date: 01-11-2020
Publisher: Springer Vienna
Keywords: Craniotomy
Antibiotic
Cefuroxime
Published in: Acta Neurochirurgica / Issue 11/2020
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-020-04309-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Preoperative antibiotic prophylaxis regimen in brain tumour surgery in Sweden: a quasi-experimental study

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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