Single‐ Versus Multiple‐dose Antibiotics Prophylaxis for Cardiac Surgery

Abstract

An in-hospital infection rate of 2.8% compares favourably with other reported series. Single-dose antimicrobial prophylaxis is as effective as a 48-h regimen. Targeting high-risk groups is effective.

Glycopeptides Are No More Effective than -Lactam Agents for Prevention of Surgical Site Infection after Cardiac Surgery: A Meta-analysis

“…Absent compelling evidence supporting a switch from blactams to glycopeptides for cardiac surgery prophylaxis, many health care centers are, nevertheless, opting to do so, often in response to high MRSA SSI rates [45] or for selected patients who are believed to have a high likelihood of MRSA colonization [25]. The findings of this study do not support such action and provide guidance for further investigation in this area.…”

“…Three further trials were excluded. One trial was not randomized; rather, teicoplanin had been selectively administered to "high-risk patients" [25]. In another trial, vancomycin was administered as postprocedure prophylaxis, and thus the trial did not fit the criterion that a study involve preoperative prophylaxis [26].…”

Early Audit of Renal Complications in a New Cardiac Surgery Service in Australia

“…27,28 The Geelong Hospital unit has already published wound infection rates for the first 353 patients, which are the lowest in the world literature. 29 The achievement of a low renal failure rate after cardiac surgery is encouraging for a new, relatively small unit and justifies the implementation of strict protocols for the management of at risk patients in the planning stage of the service (see Appendix). We propose that all cardiac surgery services should prospectively collect, audit and disseminate data on complications and mortality rates according to well-defined and agreed criteria to allow internal and external comparisons.…”

Cardiac surgery antibiotic prophylaxis and calculated empiric antibiotic therapy

“…7 Besides these results, many other reports have noted that increasing the duration of antibiotic prophylaxis in cardiac surgery patients did not result in a significant decrease in surgical site infections. [8][9][10][11] Concerning the international guidelines for antibiotic prophylaxis, there are heterogeneous data. There is no recommendation of singledose administration or for regimen longer than a 48 h. Most guidelines suggest that prophylaxis for 48 h or less may be appropriate for cardiothoracic procedures (evidence level B, class IIa).…”