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Observational Study
. 2015 Feb 26:10:25.
doi: 10.1186/s13019-015-0225-x.

Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study

Khaled Hamouda  1 , Mehmet Oezkur  2 , Bhanu Sinha  3 , Johannes Hain  4 , Hannah Menkel  5 , Marcus Leistner  6 , Rainer Leyh  7 , Christoph Schimmer  8
Affiliations
Observational Study

Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study

Khaled Hamouda et al. J Cardiothorac Surg. .

Abstract

Background: All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial.

Methods: Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac surgery patients were assigned to one of two groups receiving PAB with a second-generation cephalosporin for either 56 h (group I) or 32 h (group II). Patients' characteristics, intraoperative data, and the in-hospital follow-up were analysed. Primary endpoint was the incidence of surgical site infection (deep and superficial sternal wound-, and vein harvesting site infection; DSWI/SSWI/VHSI). Secondary endpoints were the incidence of respiratory-, and urinary tract infection, as well as the mortality rate.

Results: 615/1096 patients (56,1%) were enrolled (group I: n = 283 versus group II: n = 332). There were no significant differences with regard to patient characteristics, comorbidities, and procedure-related variables. No statistically significant differences were demonstrated concerning primary and secondary endpoints. The incidence of DSWI/SSWI/VHSI were 4/283 (1,4%), 5/283 (1,7%), and 1/283 (0,3%) in group I versus 6/332 (1,8%), 9/332 (2,7%), and 3/332 (0,9%) in group II (p = 0,76/0,59/0,63). In univariate analyses female gender, age, peripheral arterial obstructive disease, operating-time, ICU-duration, transfusion, and respiratory insufficiency were determinants for nosocomial infections (all ≤ 0,05). Subgroup analyses of these high-risk patients did not show any differences between the two regimes (all ≥ 0,05).

Conclusions: Reducing the duration of PAB from 56 h to 32 h in adult cardiac surgery patients was not associated with an increase of nosocomial infection rate, but contributes to reduce antibiotic resistance and health care costs.

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Figure 1
Trial profile.
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References

    1. Edwards FH, Engelmann RM, Houck P. The society of thoracic surgeons practice guideline series: antibiotic prophylaxis in cardiac surgery, part I: duration. Ann Thorac Surg. 2006;81:397–404. doi: 10.1016/j.athoracsur.2005.06.034. - DOI - PubMed
    1. Gupta A, Hote MP, Choudhury M, Kapil A, Bisoi AK. Comparison of 48 h and 72 h of prophylactic antibiotic therapy in adult cardiac surgery: a randomized double blind controlled trial. J Antimicrob Chemother. 2010;65:1036–41. doi: 10.1093/jac/dkq080. - DOI - PubMed
    1. Nooyen SMH, Overbeek BP, de la Rivière AB. Prospective Randomised Comparison of Single-Dose versus Multiple-Dose Cefuroxime for Prophylaxis in Coronary Artery Bypass Grafting. Eur J Clin Microbiol Infect Dis. 1994;1033–37. - PubMed
    1. Bode LGM, Kluytmans JAJW, Wertheim HFL, Bogaers D, Vandenbroucke-Grauls CMJE, Roosendaal R, et al. Preventing surgical-site infections in nasal carriers of staphylococcus aureus. N Engl J Med. 2010;362:9–17. doi: 10.1056/NEJMoa0808939. - DOI - PubMed
    1. Reinhart K, Brunkhorst FM, Bone HG, Bardutzky J, Dempfle CE, Forst H. Prevention, diagnosis, therapy and follow-up care of sepsis: 1st revision of S-2 k guidelines of the German Sepsis Society and the German Interdisciplinary Association of Intensive Care and Emergency Medicine. GMS German Medical Science 2010,8 ISSN 1612–3174. - PMC - PubMed

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