Routine Antibiotics after Stroke

A multiple-indication review conducted by the CLAHRC WM Director showed that prophylactic antibiotics effectively reduced post-operative infections, with an effect size in relative risk ratio terms that was independent of the type of surgery.[1] A recent paper [2] confirmed that prophylaxis also reduced risk of infection after acute stroke. However, it did not improve functional outcomes, length of stay, or mortality, and the authors do not recommend routine use.

— Richard Lilford, CLAHRC WM Director


  1. Bowater RJ, Stirling SA, Lilford RJ. Is antibiotic prophylaxis in surgery a generally effective intervention? Testing a generic hypothesis over a set of meta-analyses. Ann Surg. 2009; 249(4): 551-6.
  2. Westendorp WF, Vermeij JD, Zock E, et al. The Preventive Antibiotics in Stroke Study (PASS): a pragmatic randomised open-label masked endpoint clinical trial. Lancet. 2015. [ePub].

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