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Systematic review
Preventive antibiotics reduce infections but not mortality in adults with acute stroke
  1. Stefan Schwarz
  1. University of Heidelberg, Germany, and Central Institute of Mental Health, Mannheim, Germany
  1. Correspondence to Stefan Schwarz
    Central Institute of Mental Health, Square J 5, 68159 Mannheim, Germany; st_schwarz{at}

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Commentary on: OpenUrlCrossRefPubMedWeb of Science

Although stroke is a major cause of death and permanent disability, its acute treatment largely remains an evidencefree zone. Currently, there are only two therapies of proven benefit. First, two randomised controlled trials showed moderate effects from thrombolysis with recombinant tissue-type plasminogen activator administered during the first 3.0 or 4.5 h after stroke, respectively. Second, decompressive surgery has been shown to reduce mortality after space-occupying stroke. Unfortunately, these therapies are applicable for a minority of stroke patients only, and there is no evidenced-based treatment for haemorrhagic stroke at all. Thus, almost all therapies and interventions performed daily in our stroke units lack solid scientific …

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  • Competing interests SS has received an unrestricted research grant from Pfizer, the manufacturer of Sulbactam, one of the antibiotic drugs studied for prevention of infection after stroke