[Clinical, bacteriological and cost-saving effects of antibiotic prophylaxis in craniotomy]

Objective of the study. To investigate the effect of antibiotic prophylaxis on the incidence of infections, on the bacterial flora of wounds and on the health-care costs. A retrospective study disclosed an incidence of infection of 8.1% in patients who underwent craniotomy. Methods. Double-blind, placebo-controlled study of the effects of cloxacillin (4 x 1 gr intravenously during 24 h, perioperatively) in 310 patients who had to undergo a craniotomy. Results. In the cloxacillin group significantly fewer infections occurred than in the placebo group, 6 infections in 156 and 20 infections in 154, respectively. In the cloxacillin group significantly fewer samples contained micro-organisms than in the placebo group. Cloxacillin prophylaxis reduces the cost of patient care by about 20%. Conclusion. Cloxacillin prophylaxis in craniotomy cases reduces the percentage of infections, the percentage of positive cultures of the wound, and the costs of patient care.