There were no statistically significant differences in mortality , infections overall and adverse events .
Perioperative antibiotic prophylaxis of ≥24 hours may be more efficacious in preventing sternal SSIs in patients undergoing cardiac surgery compared to shorter regimens .
OBJECTIVE We aim ed to compare the efficacy of short-term ( < 24 hours ) versus longer-term antibiotic prophylaxis ( ≥24 hours ) in open heart surgery .
BACKGROUND The optimal duration of antibiotic prophylaxis for adults undergoing cardiac surgery is unknown and guideline recommendations are inconsistent .
Prolonged antibiotic prophylaxis after cardiovascular surgery and its effect on surgical site infections and antimicrobial resistance.
BACKGROUND Despite evidence supporting short antibiotic prophylaxis ( ABP ) , it is still common practice to continue ABP for more than 48 hours after coronary artery bypass graft ( CABG ) surgery . METHODS AND RESULTS To compare the effect of short ( < 48 hours ) versus prolonged ( > 48 hours ) ABP on surgical site infections ( SSIs ) and acquired antimicrobial resistance , we conducted an observational 4-year cohort study at a tertiary-care center . An experienced infection control nurse performed prospect i ve surveillance of 2641 patients undergoing CABG surgery . The main exposure was the duration of  ABP  , and main outcomes were the adjusted rate of SSI and the isolation of cephalosporin-resistant enterobacteriaceae and vancomycin-resistant enterococci ( acquired antibiotic resistance ) . Adjustment for confounding was performed by multivariable modeling . A total of 231 SSIs ( 8.7 % ) occurred after a median of 16 days , including 93 chest-wound infections ( 3.5 % ) and 13 deep-organ-space infections ( 0 . 5 % ) . After 1502 procedures using short ABP , 131 SSIs were recorded , compared with 100 SSIs after 1139 operations with prolonged ABP ( crude OR , 1.0 ; CI , 0.8 to 1.3 ) . After adjustment for possible confounding , prolonged ABP was not associated with a decreased risk of SSI ( adjusted OR , 1.2 ; CI , 0.8 to 1.6 ) and was correlated with an increased risk of acquired antibiotic resistance ( adjusted OR , 1.6 ; CI , 1.1 to 2.6 ) . CONCLUSIONS Our findings confirm that continuing ABP beyond 48 hours after CABG surgery is still widespread ; however , this practice is ineffective in reducing SSI , increases antimicrobial resistance , and should therefore be avoided
There were no statistically significant differences in mortality , infections overall and adverse events .
Perioperative antibiotic prophylaxis of ≥24 hours may be more efficacious in preventing sternal SSIs in patients undergoing cardiac surgery compared to shorter regimens .
OBJECTIVE We aim ed to compare the efficacy of short-term ( < 24 hours ) versus longer-term antibiotic prophylaxis ( ≥24 hours ) in open heart surgery .
BACKGROUND The optimal duration of antibiotic prophylaxis for adults undergoing cardiac surgery is unknown and guideline recommendations are inconsistent .