[A prospective, randomized comparative study between cefazolin and cefuroxime as perioperative antibiotic prevention in cardiovascular surgery]

Abstract

In a randomized prospective study, two different regimens of antibiotic prophylaxis have been tested: 4-day cefazolin prophylaxis (Kefzol, 0.5 g every 6 h) compared with 2-day cefuroxime administration (Zinacef, 1.5 g every 12 h). A total of 569 patients in the two groups were studied over a 10 months' period. Hematological, liver-function, serum creatinine and urea measurements were performed preoperatively and repeated daily for the first four days and after one week. At least five chest X-rays were taken during the hospitalization. Body temperature was measured regularly every two hours in the ICU and at least twice daily thereafter. The wounds were examined daily and the patients were carefully observed for other infections. Bacteriological examinations of the tips of all inserted catheters and pacemaker wires were undertaken on removal in the first four months of the trial. Swabs of any tracheal or wound secretion or pus were taken for bacteriological examinations, and blood cultures were performed for any suspected septicemia. Of the 569 patients, 3 had to be withdrawn from the study. Of the assessable patients, 285 received cefuroxime and 281 were given cefazolin. Seven patients (1.2%) died intra- or postoperatively. The total infection rate was 5.5%; 5.7% in the cefazolin group and 5.3% in the cefuroxime group. The overall wound infection rate was 1.8%; 2.5% in the cefazolin group and 1.1% in the cefuroxime group. Septicemia occurred in 0.5%, pneumonia in 11 patients (1.9%); 1.5% in the cefazolin and 2.5% in the cefuroxime group. Seven patients (1.2%) developed a urinary tract infection; 1.4% on the cefazolin group and 1.1% in the cefuroxime group.(ABSTRACT TRUNCATED AT 250 WORDS)