Efficacy of Short-Term versus Long-Term Post-Operative Antimicrobial Prophylaxis for Preventing Surgical Site Infection after Clean Neurosurgical Operations

Surgical site infection (SSI) is a problem constantly uppermost in the minds of all surgeons, although the actual rate of occurrence is only 1-5% in general surgery. SSI leads to increases in the cost of care as well as, prolonged hospital stays. Furthermore, in the field of neurosurgery, SSI may result in increased morbidity and mortality, or may induce critical neurologic deficits that have a direct impact on quality of life. It is well known that pre-operative antimicrobial prophylaxis (AMP) can reduce SSI acquired at the time of surgery and has been routinely employed in many surgical fields. However, in neurosurgical field post-operative antimicrobial prophylaxis (PAMP) has been employed practically to cover the SSI not only acquired at the time of surgery but also after the surgery. In other surgical fields short-term PAMP (PAMP for less than one day) was recommended instead of long-term PAMP (PAMP for more than one week), because long-term PAMP may induce numerous side effects such as hypersensitivity reaction or increasing prevalence of antibiotic-resistant bacteria. Few papers have been published about the efficacy of short-term PAMP to prevent SSI in neurosurgical field. Despite general recommendation of short-term PAMP, prolonged antibiotic use is still commonEfficacy of Short-Term versus Long-Term Post-Operative Antimicrobial Prophylaxis for Preventing Surgical Site Infection after Clean Neurosurgical Operations