Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Sep;98(3):927-33.
doi: 10.1016/j.athoracsur.2014.04.090. Epub 2014 Jul 16.

Implementing a standardized perioperative antibiotic prophylaxis protocol for neonates undergoing cardiac surgery

Meghan T Murray  1 , Rozelle Corda  2 , Rebecca Turcotte  3 , Emile Bacha  4 , Lisa Saiman  5 , Ganga Krishnamurthy  6
Affiliations

Implementing a standardized perioperative antibiotic prophylaxis protocol for neonates undergoing cardiac surgery

Meghan T Murray et al. Ann Thorac Surg. 2014 Sep.

Abstract

Background: A lack of perioperative antibiotic prophylaxis guidelines for neonates undergoing cardiac surgery has resulted in a wide variation in practice. We sought to do the following: (1) Determine the safety of a perioperative antibiotic prophylaxis protocol for neonatal cardiac surgery as measured by surgical site infections (SSIs) rates before and after implementation of the protocol; and (2) evaluate compliance with selected process measures for perioperative antibiotic prophylaxis.

Methods: This quasi-experimental study included all cardiac procedures performed on neonates from July 2009 to June 2012 at a single center. An interdisciplinary task force developed a standardized perioperative antibiotic prophylaxis protocol in the fourth quarter of 2010. The SSI rates were compared in the preintervention (July 2009 to December 2010) versus the postintervention periods (January 2011 to June 2012). Compliance with process measures (appropriate drug, dose, timing, and discontinuation of perioperative antibiotic prophylaxis) was compared in the 2 periods.

Results: During the study period, 283 cardiac procedures were performed. The SSI rates were similar in the preintervention and postintervention periods (6.21 vs 5.80 per 100 procedures, respectively). Compliance with the 4 process measures significantly improved postintervention.

Conclusions: Restricting the duration of perioperative antibiotic prophylaxis after neonatal cardiac surgery to 48 hours in neonates with a closed sternum and to 24 hours after sternal closure was safe and did not increase the rate of SSIs. Compliance with selected process measures improved in the postintervention period. Additional multicenter studies are needed to develop national guidelines for perioperative prophylaxis for this population.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Above figure describes a flow diagram of patient population and procedures.
See this image and copyright information in PMC

References

    1. De Lissovoy G, Fraeman K, Hutchins V, Murphy D, Song D, Vaughn BB. Surgical site infection: Incidence and impact on hospital utilization and treatment costs. Am J Infect Control. 2009;37:387–397. - PubMed
    1. Levy I, Ovadia B, Erez E, et al. Nosocomial infections after cardiac surgery in infants and children: incidence and risk factors. J Hosp Infect. 2003;53(2):111–116. - PubMed
    1. Costello JM, Graham DA, Morrow DF, et al. Risk factors for surgical site infection after cardiac surgery in children. Ann Thorac Surg. 2010;89(6):1833–1841. - PubMed
    1. Allpress AL, Rosenthal GL, Goodrich KM, Lupinetti FM, Zerr DM. Risk factors for surgical site infections after pediatric cardiovascular surgery. Pediatr Infect Dis J. 2004;23:231–234. - PubMed
    1. Nateghian A, Taylor G, Robinson JL. Risk factors for surgical site infections following open-heart surgery in a Canadian pediatric population. Am J Infect Control. 2004;32:397–401. - PubMed

Publication types

MeSH terms