[Prophylactic use of penicillin G and ampicillin in stroke. I. Clinical observations]

In 103 patients with strokes without associated infections the prophylactic usefulness of antibiotics was assessed clinically. In 30 patients (group I) and 27 patients (group II) ampicillin was used in daily doses of 2-4 g or penicillin (Polfa) was given 2.4-4.8 million i.u. during 10 days. In the remaining 46 cases (group III) no antibiotics were given and these patients served as controls. During the first 10 days after stroke onset infectious complications developed significantly less frequently in controls (in 15 cases, i.e. 33%) than in those receiving antibiotic phophylaxis (40 cases i.e. 70%). The difference between the groups was statistically significant (p less than 0.001). In the second ten-day period no clinical evidence of new infection was observed in any group. It may be supposed in the light of these diseases that administration of penicillin G or ampicillin to patients with strokes without carrying out antibiotic sensitivity tests is unnecessary. Nearly exclusively pneumonia and urinary tract infection appear in the first ten days after stroke onset which may suggest acute and gradually levelling-off of the neuroregulation of immunological defense mechanisms.