The potential impact of clindamycin on neurosurgery patients: a randomized controlled trial

TL;DR

This study explores if adding clindamycin to standard care after neurosurgery helps reduce brain damage and improve recovery.

Contribution

The study introduces clindamycin as a potential neuroprotective adjunct in post-neurosurgery care.

Findings

Clindamycin significantly reduced neuron-specific enolase levels, indicating less brain damage.

Neurotensin levels were lower in the clindamycin group, suggesting reduced inflammation and neuronal apoptosis.

Glasgow Coma Scale scores showed no significant difference between the groups on day 3.

Abstract

The study investigates whether adding clindamycin to neurosurgery patients’ as a postsurgical management regimen improves recovery, provides neuroprotection, and prevents neurological complications. Neuron-specific enolase (NSE) and neurotensin (NT) were measured as biomarkers of inflammation, brain damage, and neuronal apoptosis.

Patients were randomly assigned into two groups (n = 22 each) to receive the standard management plus either ceftriaxone (2 g / 12 h) or plus ceftriaxone and clindamycin (900 mg/8 h) as a combination therapy for seven days.

NSE serum levels in the clindamycin and control group on day 3 were (10.01 ± 1.64) versus (23.77 ± 11.75), respectively (p = 0.0001). NT serum levels in the clindamycin and control groups on day 3 were (4.5 ± 2.8) versus (8.29 ± 7.97), respectively (p = 0.0418). Glasgow Coma Scale (GCS) on day 3 was (14.32 ± 1.13) versus (14.23 ± 1.31) in the clindamycin and the control groups, respectively, (p = 0.724). SOFA score assessed on day 3 (5 (22.7%)) and (1 (4.5%)) had grade 1, (15 (68.25)) and (14 (63.35)) had grade 2, (1 (4.5%)) and (5 (22.7%)) had grade 3, (0 (0.0%)) and (1 (4.5%)) had grade 4, and (1 (4.5%)) and (1 (4.5%)) had grade 5 in the clindamycin and control groups, respectively.

Adjunctive use of clindamycin might be a novel option that reduces secondary neurological injury/damage after neurosurgeries. Further and more extensive clinical trials are warranted to confirm the findings.

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