Does One Week of Postoperative Antibiotic Prophylaxis Reduce the Rate of Infection After Vagus Nerve Stimulator Surgery?

OBJECTIVE: Vagus nerve stimulation (VNS) therapy is an increasingly popular treatment for medically intractable epilepsy. During a review of our cases, we noted that one of the senior authors give patients 1 week of antibiotic prophylaxis after VNS surgery while the other does not. We reviewed our experience with postoperative antibiotic prophylaxis after VNS surgery. METHODS: We retrospectively reviewed the records of patients from January 2009 to September 2018 who had -ndergone surgery for VNS therapy, including generator replacement. The office and operative notes were reviewed to obtain the indications and operative details for VNS placement. RESULTS: A total of 570 operations were reviewed, 232 of which were primary implantations and 338 were revisions. The indication was intractable epilepsy in all cases. A total of 5 infections occurred, 4 in the group with postoperative antibiotic prophylaxis and 1 in the group without. The difference was not statistically significant. CONCLUSION: Just as with any hardware implantation, infection of the hardware can lead to significant morbidity. However, the use of postoperative oral antibiotic prophylaxis did not show benefit in reducing the infection rate.