Adverse financial and clinical burden of the use of prophylactic antibiotics in neurosurgical patients.

Background: Current guidance does not support the administration of prophylactic antibiotics in non-infected post-operative surgical cases including neurosurgery. Materials and methods: This paper is a qualitative assessment, highlighting the economic cost of excessive antimicrobial prescription and the healthcare costs of the extra days of admission in hospital. Results: One hundred and one neurosurgical cases were analysed in a single institution over a one-year period. The additional course of post-operative antibiotics has a cost of £56.72 and receiving prolonged post-operative antibiotics added on average £1121.10 to their admission bill. Up to 13.4 patients may have experienced an adverse drug event. Conclusion: This paper reinforces the adherence to guidelines can aid in the reduction of adverse drug events, improve patient outcomes, and reduce costs associated with unnecessary drug prescriptions and administration.

Intratumoral and Peritumoral Brain Abscess Concomitant with Glioblastoma: Report of Two Cases with Review of Literature.

Intracranial abscess coexistent with a high grade glioma, without prior surgical intervention, is an unusual occurrence. This paper presents two such cases with Nocardia farcinica abscess surrounding the glioblastoma in an immunocompromised individual and Enterococcus faecium abscess within the glioblastoma in an immunocompetent patient. Adjuvant therapy was tapered as per each patient's clinical response. Till date, only eight cases of coexistent high-grade glioma and brain abscess have been reported in literature. This report stands distinct in highlighting the need to radiologically evaluate each foci of a multicentric cranial lesion on its own merit.