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Chemoprophylaxis in neurosurgery departments in Croatia and Greece

Aim: The aim of the present study was to compare the status of Chemoprophylaxis in Neurosurgery Departments of two University Hospitals in Croatia and in Greece, and to check if general guidelines for Chemoprophylaxis in Neurosurgery are met. Methods: The Neurosurgery Clinic of the University Hospital Rijeka and the 2nd Clinic of Neurosurgery of the Hippokrateion Hospital of Thessaloniki were chosen for the study. The Croatian and Greek surgeons replied to the same questionnaire, which investigated the conformance to the recommended guidelines and the behavior of the surgeons in Neurosurgical Chemoprophylaxis in patients having a low or a high risk for a post-operative infection. The following issues in Chemoprophylaxis were checked: 1) application of chemoprophylaxis, 2) duration and time of initiation of chemoprophylaxis and 3) the kind of antibiotics used. Results: In patients with a low risk for a post-operative infection, Croatian surgeons do not use chemoprophylaxis in the following operations: closed craniocerebral injury, spinal injury, peripheral nerves injury, CNS tumors, hydrocephalus and vascular malformations. Greek surgeons use chemoprophylaxis in all kinds of Neurosurgery. In most cases chemoprophylaxis is initiated during preinduction to anesthesia and its duration usually exceeds 24 hours. Both Croatian and Greek surgeons use a β -lactam for chemoprophylaxis but in some cases the Greek surgeons use also vancomycin when MRSA is suspected. Conclusions: The behavior of Croatian and Greek neurosurgeons in application of antimicrobial chemoprophylaxis reflects the status of microbial resistance in each country, as well as their fear of CNS infections.

antibiotics; peri-operative chemoprophylaxis; CNS infections

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