There was no advantage of regimens lasting > 48 h post-operation .
In the comparison of glycopeptides versus β-lactams , an advantage of glycopeptides was observed when comparators were given for similar duration and for β-lactams when given for a longer duration than the glycopeptides .
There was no significant advantage of high antibiotic dosing .
Evidence supports second- or third-generation cephalosporins for cardiac surgery prophylaxis and points at a possible advantage of prophylaxis prolongation up to 48 h post-operatively
BACKGROUND Antibiotic prophylaxis is recommended in cardiac surgery .
Current debate concerns the type of antibiotic(s ) , dosing and the duration of prophylaxis .
Cefamandole versus cefonicid prophylaxis in cardiovascular surgery: a prospective study.
We r and omized 400 patients who were scheduled for an elective cardiovascular operation involving median sternotomy to receive cefam and ole nafate or cefonicid in a prospect i ve double-blind study . Three hundred fifty-seven patients were evaluable for prophylactic efficacy . Chest wound and donor site infections and early prosthetic valve endocarditis occurred more frequently with cefonicid ( 11 patients , 6.3 % ) than with cefam and ole ( 4 patients , 2.2 % ) ( p = 0.05 ) . Three patients , all in the cefonicid group , required sternal debridement to control postoperative deep wound infections . Twenty-five miscellaneous postoperative infections ( urinary tract infection , pneumonia , intravenous site infection , bacteremia , sepsis , Clostridium difficile diarrhea ) occurred in 16 patients ( 9.19 % ) in the cefonicid group and four in 4 patients ( 2.19 % ) in the cefam and ole group ( p = 0.003 ) . These data indicate that cefam and ole is superior to cefonicid in preventing both surgical wound infections and miscellaneous nonsurgical infections after cardiovascular operations
There was no advantage of regimens lasting > 48 h post-operation .
In the comparison of glycopeptides versus β-lactams , an advantage of glycopeptides was observed when comparators were given for similar duration and for β-lactams when given for a longer duration than the glycopeptides .
There was no significant advantage of high antibiotic dosing .
Evidence supports second- or third-generation cephalosporins for cardiac surgery prophylaxis and points at a possible advantage of prophylaxis prolongation up to 48 h post-operatively
BACKGROUND Antibiotic prophylaxis is recommended in cardiac surgery .
Current debate concerns the type of antibiotic(s ) , dosing and the duration of prophylaxis .