@article{SuratBernsenSchimmer2021,
  author    = {Surat, G{\"u}zin and Bernsen, Dominik and Schimmer, Christoph},
  title     = {Antimicrobial stewardship measures in cardiac surgery and its impact on surgical site infections},
  series = {Journal of Cardiothoracic Surgery},
  volume    = {16},
  journal   = {Journal of Cardiothoracic Surgery},
  doi       = {10.1186/s13019-021-01693-7},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265533},
  year      = {2021},
  abstract  = {Objective The goal of this study was to monitor the compliance and impact on a protocol change of surgical antimicrobial prophylaxis in cardiac surgery favouring cefazolin instead cefuroxime, initiated by the hospital's antimicrobial stewardship team. Methods This quality improvement study was performed in a tertiary care hospital in collaboration with the department of cardiothoracic surgery and the hospitals antimicrobial stewardship team following a revision of the standard for surgical antimicrobial prophylaxis including 1029 patients who underwent cardiac surgery. 582 patients receiving cefuroxime and 447 patients receiving cefazolin respectively were compared without altering any other preventative perioperative measures including its postoperative duration of less than 24 h. Adherence and surgical site infections were compiled and analysed. Results A complete adherence was achieved. Overall surgical site infections occurred in 37 (3.6\%) of the cases, 20 (3.4\%) in cefuroxime patients and 17 (3.8\%) in cefazolin patients (p value = 0.754). No statistically significant differences could be found in any of the primary endpoints, but there was a trend towards less deep sternal wound infections in the cefazolin group. Conclusions The study supports the role of antimicrobial stewardship in cardiac surgery and mirrors the success of a multidisciplinary team aiming to minimize adverse events by optimizing antibiotic use.},
  language  = {en}
}
@article{HamoudaOezkurSinhaetal.2015,
  author    = {Hamouda, Khaled and Oezkur, Mehmet and Sinha, Bhanu and Hain, Johannes and Menkel, Hannah and Leistner, Marcus and Leyh, Rainer and Schimmer, Christoph},
  title     = {Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study},
  series = {Journal of Cardiothoracic Surgery},
  volume    = {10},
  journal   = {Journal of Cardiothoracic Surgery},
  number    = {25},
  doi       = {10.1186/s13019-015-0225-x},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-124977},
  year      = {2015},
  abstract  = {Background All international guidelines recommend perioperative antibiotic prophylaxis (PAB) should be routinely administered to patients undergoing cardiac surgery. However, the duration of PAB is heterogeneous and controversial. Methods Between 01.01.2011 and 31.12.2011, 1096 consecutive cardiac surgery patients were assigned to one of two groups receiving PAB with a second-generation cephalosporin for either 56 h (group I) or 32 h (group II). Patients' characteristics, intraoperative data, and the in-hospital follow-up were analysed. Primary endpoint was the incidence of surgical site infection (deep and superficial sternal wound-, and vein harvesting site infection; DSWI/SSWI/VHSI). Secondary endpoints were the incidence of respiratory-, and urinary tract infection, as well as the mortality rate. Results 615/1096 patients (56,1\%) were enrolled (group I: n = 283 versus group II: n = 332). There were no significant differences with regard to patient characteristics, comorbidities, and procedure-related variables. No statistically significant differences were demonstrated concerning primary and secondary endpoints. The incidence of DSWI/SSWI/VHSI were 4/283 (1,4\%), 5/283 (1,7\%), and 1/283 (0,3\%) in group I versus 6/332 (1,8\%), 9/332 (2,7\%), and 3/332 (0,9\%) in group II (p = 0,76/0,59/0,63). In univariate analyses female gender, age, peripheral arterial obstructive disease, operating-time, ICU-duration, transfusion, and respiratory insufficiency were determinants for nosocomial infections (all ≤ 0,05). Subgroup analyses of these high-risk patients did not show any differences between the two regimes (all ≥ 0,05). Conclusions Reducing the duration of PAB from 56 h to 32 h in adult cardiac surgery patients was not associated with an increase of nosocomial infection rate, but contributes to reduce antibiotic resistance and health care costs.},
  language  = {en}
}