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 .
Incidence and risk factors for ventilator-associated pneumonia after major heart surgery
Purpose Major heart surgery ( MHS ) patients are a particularly high-risk population for nosocomial infections . Our objective was to identify risk factors for ventilator-associated pneumonia ( VAP ) in patients undergoing MHS .  Methods Prospect i ve study including 1,844 patients operated from 2003 to 2006 . Results Overall 106 patients ( 140 episodes ) developed one or more episodes of VAP ( 5.7 % , 22.2 episodes per 1,000 days of mechanical ventilation ) . VAP incidence was 45.9 % in those patients requiring more than 48 h of MV . Enterobacteriaceae ( 32.8 ) , Pseudomonas aeruginosa ( 28.6 % ) and Staphylococcus aureus ( 27.1 % , of which 65.8 % were methicillin resistant ) were the principal microorganisms causing VAP . The independent risk factors for VAP were : age > 70 , perioperative transfusions , days of mechanical ventilation , reintubation , previous cardiac surgery , emergent surgery and intraoperative inotropic support . Median length of stay in the ICU for patients who developed VAP or not was , respectively , 25.5 versus 3 days ( P < 0.001 ) , and mortality was , respectively , 45.7 versus 2.8 % in both population s ( P < 0.001 ) . We developed a predictive preoperative score with a sensitivity of 93 % and a specificity of 40 % . Conclusions VAP is common in patients undergoing MHS that require more than 48 h of MV .  In that “ high-risk ” population , innovative preventive measures should be developed and applied
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 .