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We appreciate the illustrative comments and widened perspective given by D’Allesandris et al. on the subject of pre-operative prophylaxis in intracranial tumor surgery. The description of the microbiological features of Cutibacterium (Propionibacterium) acnes, including its antibiotic resistance pattern, highlights the importance of an accurate choice of pre-operative antibiotic prophylaxis.
As pointed out by D’Allesandris and colleagues, also indolent surgical site infections (SSIs) caused by C. acnes may cause severe consequences for the neurosurgical patient, such as bone flap osteomyelitis and abscesses [1, 2]. In our study, we also found that an accurate antibiotic prophylaxis reduced the risk of SSI and thereby the need for broad-spectrum antibiotic treatment, including vancomycin and imipenem.
References
Haruki Y et al (2017) Risk factors for Propionibacterium acnes infection after neurosurgery: a case-control study. J Infect Chemother 23:256–258
Pietropaoli C et al (2020) Cerebral empyema and abscesses due to Cutibacterium acnes. Med Mal Infect 50:274–279
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Skyrman, S., Bartek, J., Haghighi, M. et al. In response to: “Effective prophylaxis regimens against Cutibacterium acnes in Neurosurgery” by d’Alessandris et al.. Acta Neurochir 163, 2695 (2021). https://doi.org/10.1007/s00701-021-04771-w
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DOI: https://doi.org/10.1007/s00701-021-04771-w