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64th Annual Meeting of the German Society of Neurosurgery (DGNC)

German Society of Neurosurgery (DGNC)

26 - 29 May 2013, Düsseldorf

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Third-generation cephalosporins compared to other conservative antibiotic regimens prophylaxis in neurosurgery – A meta-analysis

Meeting Abstract

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  • Weiming Liu - Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical Univerity, Beijig, China; Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
  • Marian C. Neidert - Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
  • Christoph Woernle - Department of Neurosurgery, University Hospital Zurich, Zurich, Switzerland
  • R. J. M. Groen - Department of Neurosurgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

Deutsche Gesellschaft für Neurochirurgie. 64. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC). Düsseldorf, 26.-29.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. DocP 015

doi: 10.3205/13dgnc436, urn:nbn:de:0183-13dgnc4367

Published: May 21, 2013

© 2013 Liu et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To analysis whether third-generation Cephalosporins as prophylactic antibiotics are superior to other conservative regimen to protect surgical site infection (SSI) in neurosurgical procedures.

Method: Data on SSI as end-point from randomized controlled trials (RCTs), which compared between third-generation cephalosporins and conservative regimens for prophylaxis in neurosurgical procedures, were pooled in a fixed-effects meta-analysis.

Results: Five prospective randomized trials enrolling 2209 patients were identified in all kinds of SSI. The pooled odds ratio for all kinds of SSI with third-generation cephalosporins prophylaxis in the five RCTs was 0.94 (95% CI, 0.59-1.52; P=0.81). It shows no significant difference between two regimens. When analysing organ SSI, four trials enrolling 1596 patients, the pooled odds ratio for organ SSI with third-generation cephalosporins prophylaxis in the four RCTs was 0.88 (95% CI, 0.45-1.74; P=0.72), so there is no advantage when third-generation cephalosporin prophylaxis is used.

Conclusions: Third-generation Cephalosporin prophylaxis has no more benefit than other regimens in neurosurgical procedures; whether for incision or organ SSI. Fearing side effects of widely used third-generation cephalosporins, we should stop using them for prophylaxis in neurosurgery until further study proved their merits.