A 68-year-old man sustains an acute subdural hematoma and grossly contaminated（受污染的） open skull fracture in a fall. He has diabetes mellitus and hypertension. He is admitted requiring surgical evacuation.
Which of the following is the best recommendation regarding antibiotic prophylaxis（预防） in this patient?
A. No antibiotic prophylaxis is required.
B. Antibiotic prophylaxis is required only if the patient is febrile.
C. Anaerobic coverage with metronidazole is required.
D. A combination of vancomycin and ceftazidime is required.
E. Antifungal coverage with fluconazole is required.
答案解析：
在某些情况下需要抗生素预防，以防止术后感染。在一项前瞻性随机试验中，接受围手术期预防性抗生素治疗的患者术后感染显著减少。病原菌多为革兰氏阳性菌；第一代头孢菌素应足矣。万古霉素和头孢他啶联合可用于严重污染伤口。
正确答案：D
补充内容：抗菌药物临床应用指导原则2015版
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