Abstract
Post-stroke complications are very common worldwide and the most common complication is infection. This contributes the most to the mortality rate in stroke patients. Among the infections, pneumonia and urinary tract infections are most common. Hyperthermia following stroke is associated with neuronal damage and worse outcomes. Post-stroke immunosuppression and activation of inflammatory mediators also cause infections. Based on the high mortality caused by post-stroke infections, various trials were done to seek the advantage that prophylactic antibiotics can give in the critical care of stroke patients. Antibiotics, including ceftriaxone (cephalosporin), levofloxacin (fluoroquinolone), penicillin, and minocycline (tetracycline), were used and the stroke patients were followed up to analyze the primary and secondary outcomes. It was concluded that early antibiotic therapy (mostly within 24 hours) leads to a reduced rate of post-stroke infections and reduced fever spikes, whereas follow-up for a longer period of time showed no better functional outcome. Furthermore, mortality and morbidity benefits were also not seen with prophylactic antibiotic therapy. This review helped us to put a nail in the coffin to the earlier thoughts that prophylactic antibiotics are necessary for the critical care of stroke patients.
Highlights
BackgroundA stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked
Based on the high mortality caused by post-stroke infections, various trials were done to seek the advantage that prophylactic antibiotics can give in the critical care of stroke patients
The objectives of this study were to see whether the use of prophylactic antibiotics in stroke patients reduced the risk of acute infections, was associated with better functional outcomes in follow-up visits, was associated with reduced post-stroke mortality and morbidity, and whether it reduced the length of hospital stay
Summary
A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Brain cells start to die after a few minutes. Sudden bleeding in the brain can cause a stroke if it damages brain cells. Stroke is the second leading cause of death after coronary artery disease. Most of the deaths caused to stroke patients are due to infections. Pneumonia and urinary tract infections are most common [1,2]
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