Neurosurgery

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Infection/Condition and Likely Organism

Suggested Treatment

Comments

Preferred Treatment

Alternative Treatment

Antibiotic prophylaxis NOT RECOMMENDED for:

  • Basal skull fractures
  • Traumatic CSF fistula
  • Post-surgical CSF leak

 

Depressed skull fractures

Cefuroxime 1.5gm IV q8h

PLUS

Metronidazole 500mg IV q8h

 

Duration 5-7 days.

Review tetanus status of patient and consider vaccination.

Penetrating craniocerebral injuries

Ceftriaxone 2gm IV q12h

PLUS

Metronidazole 400mg PO q8h

 

Duration: 2 weeks initially and then review with microbiology.
References
  1. Salford Royal, NHS. Antibiotic Prophylaxis in Cranial Neurosurgery Antibiotic Guidelines, Unique ID: 144TD(C)25(F4) Issue number: 6, 2018.
  2. National Antimicrobial Guideline, Third Edition. Petaling Jaya: Ministry of Health, Malaysia; 2019.