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Different duration strategies of perioperative antibiotic prophylaxis in adult patients undergoing cardiac surgery: an observational study

Please always quote using this URN: urn:nbn:de:bvb:20-opus-124977
  • 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.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.show moreshow less

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Metadaten
Author: Khaled Hamouda, Mehmet Oezkur, Bhanu Sinha, Johannes Hain, Hannah Menkel, Marcus Leistner, Rainer Leyh, Christoph Schimmer
URN:urn:nbn:de:bvb:20-opus-124977
Document Type:Journal article
Faculties:Fakultät für Mathematik und Informatik / Institut für Informatik
Medizinische Fakultät / Klinik und Poliklinik für Thorax-, Herz- u. Thorakale Gefäßchirurgie
Language:English
Parent Title (English):Journal of Cardiothoracic Surgery
Year of Completion:2015
Volume:10
Issue:25
Source:Journal of Cardiothoracic Surgery (2015) 10:25 DOI 10.1186/s13019-015-0225-x
DOI:https://doi.org/10.1186/s13019-015-0225-x
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 617 Chirurgie und verwandte medizinische Fachrichtungen
Tag:antibiotic prophylaxis; cardiac surgery; nosocomial infection
Release Date:2016/02/02
Collections:Open-Access-Publikationsfonds / Förderzeitraum 2015
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung