| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
J Thorac Cardiovasc Surg 2002;123:326-332
© 2002 The American Association for Thoracic Surgery
Surgery for Acquired Cardiovascular Disease (ACD) |
From Rambam Medical Centera and Technion-Israel Institute of Technology,b Haifa, Israel.
Received for publication April 23, 2001; revisions requested June 6, 2001 Revisions received July 12, 2001. Accepted for publication July 20, 2001. Address for reprints: R. Finkelstein, MD, Infectious Diseases Unit, Rambam Medical Center, Haifa 31096, Israel (E-mail: rfinkelstein{at}rambam.health.gov.il).
Objective: This study was undertaken to compare the efficacy of vancomycin prophylaxis with that of cefazolin in preventing surgical site infections in a tertiary medical center with a high prevalence of methicillin-resistant staphylococcal infections.
Methods: All adult patients (
18 years) scheduled for cardiac surgery requiring sternotomy were randomly assigned to receive vancomycin (1 g every 12 hours) or cefazolin (1 g every 8 hours). Prophylaxis was started during the induction of anesthesia and continued for only 24 hours. Patients were followed up for at least 30 days (1 year for those receiving a cardiac implant). Surgical site infections were stratified according to the National Nosocomial Infections Surveillance System risk index.
Results: Of the 885 patients included in the study, 452 received vancomycin and 433 received cefazolin. The overall surgical site infection rates were similar in the two groups (43 cases in the vancomycin group, 9.5%, vs 39 cases in the cefazolin group, 9.0%, P = .8). Superficial and deep incisional surgical site infection rates were also similar in the two groups. There was a trend toward more frequent organ-space infections and infections with ß-lactam–resistant organisms among patients receiving cefazolin, but this trend did not reach statistical significance. In contrast, surgical site infections caused by methicillin-susceptible staphylococci were significantly more common in the vancomycin group (17 cases, 3.7%, vs 6 cases, 1.3%, P = .04). The durations of postoperative hospitalization and the mortalities were similar in the two groups.
Conclusions: This trial suggests that vancomycin and cefazolin have similar efficacy in preventing surgical site infections in cardiac surgery.
This article has been cited by other articles:
|
|
 |
|
  E. Tamayo, J. Gualis, S. Florez, J. Castrodeza, J. M. Eiros Bouza, and F. J. Alvarez Comparative study of single-dose and 24-hour multiple-dose antibiotic prophylaxis for cardiac surgery. J. Thorac. Cardiovasc. Surg., December 1, 2008; 136(6): 1522 - 1527. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Prokuski Prophylactic Antibiotics in Orthopaedic Surgery J. Am. Acad. Ortho. Surg., May 1, 2008; 16(5): 283 - 293. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. W. Garey, D. Lai, T. K. Dao-Tran, L. O. Gentry, L. Y. Hwang, and B. R. Davis Interrupted Time Series Analysis of Vancomycin Compared to Cefuroxime for Surgical Prophylaxis in Patients Undergoing Cardiac Surgery Antimicrob. Agents Chemother., February 1, 2008; 52(2): 446 - 451. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Dhadwal, S. Al-Ruzzeh, T. Athanasiou, M. Choudhury, P. Tekkis, P. Vuddamalay, H. Lyster, M. Amrani, and S. George Comparison of clinical and economic outcomes of two antibiotic prophylaxis regimens for sternal wound infection in high-risk patients following coronary artery bypass grafting surgery: a prospective randomised double-blind controlled trial Heart, September 1, 2007; 93(9): 1126 - 1133. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Fletcher, D. Sofianos, M. B. Berkes, and W. T. Obremskey Prevention of Perioperative Infection J. Bone Joint Surg. Am., July 1, 2007; 89(7): 1605 - 1618. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Engelman, D. Shahian, R. Shemin, T. S. Guy, D. Bratzler, F. Edwards, M. Jacobs, H. Fernando, and C. Bridges The Society of Thoracic Surgeons Practice Guideline Series: Antibiotic Prophylaxis in Cardiac Surgery, Part II: Antibiotic Choice Ann. Thorac. Surg., April 1, 2007; 83(4): 1569 - 1576. [Full Text] [PDF]
|
|
|
|
|
|
M. Paul, A. Raz, L. Leibovici, H. Madar, R. Holinger, and B. Rubinovitch Sternal wound infection after coronary artery bypass graft surgery: Validation of existing risk scores J. Thorac. Cardiovasc. Surg., February 1, 2007; 133(2): 397 - 403. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. W. Garey, T. Dao, H. Chen, P. Amrutkar, N. Kumar, M. Reiter, and L. O. Gentry Timing of vancomycin prophylaxis for cardiac surgery patients and the risk of surgical site infections J. Antimicrob. Chemother., September 1, 2006; 58(3): 645 - 650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Kachroo, T. Dao, F. Zabaneh, M. Reiter, M. T LaRocco, L. O Gentry, and K. W Garey Tolerance of Vancomycin for Surgical Prophylaxis in Patients Undergoing Cardiac Surgery and Incidence of Vancomycin-Resistant Enterococcus Colonization Ann. Pharmacother., March 1, 2006; 40(3): 381 - 385. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. H. Edwards, R. M. Engelman, P. Houck, D. M. Shahian, and C. R. Bridges The Society of Thoracic Surgeons Practice Guideline Series: Antibiotic Prophylaxis in Cardiac Surgery, Part I: Duration Ann. Thorac. Surg., January 1, 2006; 81(1): 397 - 404. [Full Text] [PDF]
|
|
|
|
 |
|
 Antibacterial prophylaxis in surgery: 3 - Arterial surgery in the abdomen, pelvis and lower limbs DTB, June 1, 2004; 42(6): 43 - 47. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M.-R. Movahed, B. Kasravi, and C. S. Bryan Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2004; 9(1): 13 - 20. [Abstract] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| ANN THORAC SURG | ASIAN CARDIOVASC THORAC ANN | EUR J CARDIOTHORAC SURG |
| J THORAC CARDIOVASC SURG | ICVTS | ALL CTSNet JOURNALS |
