The Efficacy of Antibacterial Prophylaxis against the Development of Meningitis after Craniotomy: a Meta-analysis.

The Efficacy of Antibacterial Prophylaxis against the Development of Meningitis after Craniotomy: a Meta-analysis.

World Neurosurg. 2016 Feb 24;

Authors: Alotaibi AF, Hulou MM, Vestal M, Alkholifi F, Asgarzadeh M, Cote DJ, Bi WL, Dunn IF, Mekary RA, Smith TR

Abstract
BACKGROUND: Prophylactic antibiotics are widely used before craniotomy to prevent postoperative infections.
OBJECTIVE: A systematic review and meta-analysis was conducted to examine the effect of prophylactic antibiotics on post-craniotomy meningitis.
METHODS: PubMed, EMBASE, and Cochrane databases were searched through October 2014 for randomized controlled trials (RCTs) that evaluated the effect of prophylactic antibiotics on post-craniotomy meningitis. Pooled effect estimates were calculated using fixed- and random-effects models.
RESULTS: Seven studies with 2365 patients were included in the final analysis. All studies were randomized controlled trials with different antibiotic regimens. Prophylactic antibiotic use reduced the rate of post-neurosurgical meningitis, with a pooled Peto Odds ratio of 0.34 (95% CI: 0.18; 0.63). Cochran's Q test indicated no significant heterogeneity among studies (I(2) =0%; P-for heterogeneity =0.44). Subgroup analysis based on gram-negative coverage, blinding design, and study quality demonstrated no statistically significant difference among these groups (P > 0.05 for all). A meta-regression on surgery duration (P=0.52) and on antibiotics duration (P=0.59) did not show significant differences in the results among studies.
CONCLUSION: This meta-analysis shows that prophylactic antibiotic use significantly decreases post-craniotomy meningitis infections.

PMID: 26921699 [PubMed - as supplied by publisher]

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