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 .
Comparative efficacy of teicoplanin and cefazolin for cardiac operation prophylaxis in 3027 patients. The ESPRIT Group.
OBJECTIVE Cephalosporins , especially cefazolin , are widely used in the prevention of postoperative wound infections after cardiac operations . As more and more Staphylococcus aureus and Staphylococcus epidermidis strains are becoming resistant to cephalosporins and other antibiotics , alternative agents , such as glycopeptides , are often used as prophylaxis . We performed a multicenter double-blind r and omized controlled trial comparing teicoplanin , a glycopeptide antibiotic , with cefazolin . METHODS A total of 3027 adult patients undergoing elective coronary artery bypass grafting , valve operations , or both were r and omized to a single dose of teicoplanin ( 15 mg/kg ) or a 2-day course of cefazolin ( 2 g initial dose , followed by 1 g every 8 hours for 6 more doses ) . Patients were followed up for a total of 6 months postoperatively . The primary objective was to compare , between groups , the incidence of surgical infections up to 30 days postoperatively . Secondary objectives were incidence of other infections , other complications , and death . RESULTS A total of 3027 patients were r and omized to receive either teicoplanin ( n = 1518 ) or cefazolin ( n = 1509 ) . Thirty days postoperatively , there was a trend to more deep sternotomy wound infections in the teicoplanin group ( 31 vs 18 , P = . 087 ) , which became significant by 6 months ( 36 vs 19 , P = .032 ) . One hundred percent of the gram-positive strains infecting patients were susceptible to teicoplanin , whereas 8.3 % were resistant to cefazolin . Pneumonia and urinary tract infections were more common in the teicoplanin group . Deep wound infections of the leg were more common in the cefazolin group . CONCLUSIONS Cefazolin was more effective prophylaxis than teicoplanin against postoperative wound infections after elective cardiac operations . Infection rates were low with either treatment
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 .