• Pouya Entezami, John W German, and Matthew A Adamo.
• Department of Neurosurgery, Albany Medical College, Albany, New York, USA. Electronic address: entezap@amc.edu.
• World Neurosurg. 2021 May 1; 149: e546-e548.

ObjectiveVagus 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.MethodsWe retrospectively reviewed the records of patients from January 2009 to September 2018 who had undergone surgery for VNS therapy, including generator replacement. The office and operative notes were reviewed to obtain the indications and operative details for VNS placement.ResultsA 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.ConclusionJust 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.Copyright © 2021 Elsevier Inc. All rights reserved.

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