dc.contributor
Institut Català de la Salut
dc.contributor
[Asensi V] Infectious Diseases-HIV Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. Microbiology and Infectious Diseases Group, FINBA-ISPA, Oviedo, Spain. [Vázquez-Fernández C, Suárez-Díaz S] Infectious Diseases-HIV Unit, Hospital Universitario Central de Asturias, Oviedo, Spain. [Asensi-Díaz E, Carrasco-Antón N] Internal Medicine Service, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain. [García-Reyne A] Internal Medicine Service, Hospital 12 Octubre, Madrid, Spain. [Biosca M] Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Asensi, Víctor
dc.contributor.author
Vázquez Fernández, Carlos
dc.contributor.author
Suárez-Díaz, Silvia
dc.contributor.author
Asensi-Díaz, Elia
dc.contributor.author
Carrasco-Antón, Nerea
dc.contributor.author
García-Reyne, Ana
dc.contributor.author
biosca, mercedes
dc.date.accessioned
2025-10-24T10:35:41Z
dc.date.available
2025-10-24T10:35:41Z
dc.date.issued
2025-02-26T08:16:49Z
dc.date.issued
2025-02-26T08:16:49Z
dc.date.issued
2024-11-26
dc.identifier
Asensi V, Vázquez-Fernández C, Suárez-Díaz S, Asensi-Díaz E, Carrasco-Antón N, García-Reyne A, et al. Extended sequential intravenous and oral antimicrobial therapy improves cure rate in postoperative intracranial neurosurgical infections: a Spanish multicenter retrospective study. BMC Infect Dis. 2024 Nov 26;24:1345.
dc.identifier
https://hdl.handle.net/11351/12653
dc.identifier
10.1186/s12879-024-10204-7
dc.identifier
001376872500001
dc.identifier.uri
https://hdl.handle.net/11351/12653
dc.description.abstract
Antimicrobial therapy; Intracranial infections; Neurosurgery
dc.description.abstract
Terapia antimicrobiana; Infecciones intracraneales; Neurocirugía
dc.description.abstract
Teràpia antimicrobiana; Infeccions intracranials; Neurocirurgia
dc.description.abstract
Background
Postoperative intracranial neurosurgical infections (PINI) complicate < 5% neurosurgeries. Scarce attention was dedicated to the extension and characteristics of its antimicrobial management considering their high morbidity, not negligible mortality, delayed hospital stay and increased healthcare costs.
Methods
We analyzed retrospectively (2014–2023) 162 PINI from eight Spanish third-level academic hospitals.
Results
Elective clean craniotomies after tumor or vascular causes were the leading procedures. Epidural abscess (24.7%), scalp infections (19.8%), postsurgical meningitis (16.7%) and cranioplasty infections (16.7%) were the most frequent PINI. Gram negative bacteria (38.6%) and Staphylococcus spp (28.6%) were the predominant isolates. Overall 85.2% patients underwent pus drainage, mostly by craniotomy (40.3%). Interestingly 34% were already receiving antibiotics for extracranial infections before developing PINI while 16.8% did not receive pre-operative antibiotic prophylaxis. In total 77.2% patients started a combined intravenous (IV) antimicrobial therapy, of which 85.2% switched after 5 days to a second-line IV antibiotic regimen, in 41.3% cases combined, after pus culture results, for a median of 21 days. Overall 61.1% patients continued on oral antimicrobials after hospital discharge, 30.3% as a combined regimen, for a median of 42 days. Complete cure was obtained in 81.5% cases, while 11.1% relapsed, 7.4% failed to cure and 6.8% died after PINI complications. In the multivariate analysis oral antimicrobial therapy after hospital discharge (p = 0.001) was significantly associated with PINI cure with no effect on survival.
Conclusions
We conclude that an extended 6 weeks sequential IV and oral antimicrobial therapy in addition to neurosurgical correction increases PINI cure rate with no effect on survival.
Clinical trial number
Not applicable.
dc.description.abstract
The Infectious Diseases Working Group of the Spanish Society of Internal Medicine (SEMI) supported and funded this study.
dc.format
application/pdf
dc.relation
BMC Infectious Diseases;24
dc.relation
https://doi.org/10.1186/s12879-024-10204-7
dc.rights
Attribution-NonCommercial-NoDerivatives 4.0 International
dc.rights
http://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Medicació oral
dc.subject
Teràpia intravenosa
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Medicaments antiinfecciosos - Ús terapèutic
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Sistema nerviós - Cirurgia
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Infeccions quirúrgiques
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DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications::Surgical Wound Infection
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DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications
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ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Surgical Procedures, Operative::Neurosurgical Procedures
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CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents
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Other subheadings::Other subheadings::/therapeutic use
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ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Drug Administration Routes::Administration, Oral
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ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Drug Therapy::Drug Administration Routes::Administration, Intravenous
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ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias::infección de la herida quirúrgica
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TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::intervenciones quirúrgicas::procedimientos neuroquirúrgicos
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COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antibacterianos
dc.subject
Otros calificadores::Otros calificadores::/uso terapéutico
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::vías de administración de medicamentos::administración oral
dc.subject
TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::farmacoterapia::vías de administración de medicamentos::administración intravenosa
dc.subject
ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias
dc.title
Extended sequential intravenous and oral antimicrobial therapy improves cure rate in postoperative intracranial neurosurgical infections: a Spanish multicenter retrospective study
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
