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 .
Respiratory tract infections after cardiac surgery: impact on hospital morbidity and mortality.
AIM Nosocomial pneumonia ( NP ) and tracheobronchitis after cardiac surgery are associated with worse outcomes . The aim of this study was to identify risk factors associated with NP and tracheobronchitis after cardiac surgery and to determine the impact of these infections on hospital morbidity and mortality . METHODS We evaluated 1600 adult patients undergoing cardiac surgery under st and ard cardiopulmonary bypass .  Data were collected prospect ively . All NP and tracheobronchitis episodes were confirmed by a semiquantitative culture of endotracheal aspirate . Logistic regression analysis was done to identify risk factors for respiratory tract infection and mortality . RESULTS The rate of NP was 1.2 % ( 15.6 episodes per 1000 days of mechanical ventilation ) and that of tracheobronchitis was 1.6 % ( 21 episodes per 1000 days of mechanical ventilation ) . Significant independent risk factors for respiratory tract infection ( pneumonia or tracheobronchitis ) were : left ventricular ejection fraction < 30 % ( P = 0.001 ) , chronic renal failure ( P < 0.0001 ) and urgent surgery ( P < 0.0001 ) . Patients with NP had significantly higher mortality ( 42 % versus 0.9 % , P < 0.0001 ) than patients without respiratory tract infection . The median hospital length of stay was significantly longer in patients with pneumonia ( 42 days ) and tracheobronchitis ( 28 days ) than in patients without any respiratory tract infection ( 11 days , P < 0.0001 ) . CONCLUSION NP after cardiac surgery is associated with severe outcomes . Independent risk markers for respiratory tract infection were left ventricular ejection fraction < 30 % , chronic renal failure and urgent surgery
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 .