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Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting

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Abstract

To assess the efficacy of single-dose antibiotic prophylaxis in coronary artery bypass grafting, 1,016 consecutive patients were prospectively randomized to receive either a single dose or a three-day course of cefuroxime. Nine patients (0.9 %) died within seven days; no death was caused by infection. For various reasons 163 other patients were not evaluable. Therefore, 844 patients were evaluated. Patients in group A (n=419) received 20 mg/kg cefuroxime intravenously at induction of anaesthesia; group B (n=425) received the same dose followed by 750 mg t.i.d. for three consecutive days. Both groups were comparable regarding all risk factors. The efficacy of the prophylactic regimens was evaluated by comparison of occurrence of wound infection in both groups. No significant differences in wound infection were observed between the two treatment groups: sternal site infection in the single-dose prophylaxis group was 14 % versus 13 % in the three-day course group; donor site infection occurred in 38 % versus 39 %. It is concluded that in coronary artery bypass grafting a single dose of cefuroxime is as effective as a three-day course in the prevention of wound infection.

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References

  1. Fong IW, Baker CB, McKee DC The value of prophylactic antibiotics in aorta-coronary bypass operations. Journal of Thoracic and Cardiovascular Surgery 1979, 78: 908–913.

    PubMed  Google Scholar 

  2. Penketh AR, Wansborough-Jones MH, Wright E, Imrie F, Pepper JR, Parloer DJ Antibiotic prophylaxis for coronary artery bypass graft surgery. Lancet 1985, i: 1500.

    Google Scholar 

  3. Slama TG, Sklar SJ, Misinski J, Fess SW Randomized comparison of cefamandole, cefazolin, and cefuroxime prophylaxis in open-heart surgery. Antimicrobial Agents and Chemotherapy 1986, 29: 744–747.

    PubMed  Google Scholar 

  4. Peterson CD, Lake KD, Arom KV, Love KR Antibiotic prophylaxis in open-heart surgery patients: comparison of cefamandole and cefuroxime. Drug Intelligence and Clinical Pharmacy 1987, 21: 728–732.

    Google Scholar 

  5. Gentry LO, Zeluff BJ, Cooley DA Antibiotic prophylaxis in open heart surgery: a comparison of cefamandole, cefuroxime and cefazolin. Annals of Thoracic Surgery 1988, 46: 167–171.

    PubMed  Google Scholar 

  6. Kouchoukos NT, Wareing TH, Murphy SF, Pelate C, Marshall WG Risk of bilateral internal mammary artery bypass grafting. Annals of Thoracic Surgery 1990, 49: 210–219.

    PubMed  Google Scholar 

  7. Burke JF The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery 1961, 50: 161–168.

    Google Scholar 

  8. Koot MJ, IJdenberg FN, Stuurman RM, Poell J, Bras LJ, Langemeijer JJM, Lie-A-Huen L High pressure liquid chromatographic analysis of the serum concentration of cefuroxime after an intravenous bolus injection of cefuroxime in patients with a coronary artery bypass grafting. Pharmaceutisch Weekblad (Scientific edition) 1992, 14: 360–364.

    Google Scholar 

  9. Garner JS, Jarvis WR, Emori TG, Horan TC, Hughes, JM CDC definitions for nosocomial infections, 1988. American Journal of Infection Control 1988, 16: 128–140.

    PubMed  Google Scholar 

  10. Austin TW, Coles JC, Burnett R, Goldback M Aortocoronary bypass procedures and sternotomy infections: a study of antistaphylococcal prophylaxis. Canadian Journal of Surgery 1980, 23: 483.

    Google Scholar 

  11. Goldmann DA, Hopkins CC, Karchmer AW, Abel RM, McEnamy MT, Akins C, Buckley MJ, Moellering RC Cephalothin prophylaxis in cardiac valve surgery: a prospective, double-blind comparison of two-day and six-day regimens. Journal of Thoracic and Cardiovascular Surgery 1977, 73: 470–479.

    PubMed  Google Scholar 

  12. Karchmer AW, Bisno AL Infections of prosthetic heart valves and vascular grafts. In: Bisno AL, Waldvogel FA (ed): Infections associated with indwelling medical devices. American Society for Microbiology, Washington DC, 1989, p. 129–159.

    Google Scholar 

  13. Scheld WM, Sande MA Endocarditis and intravascular infections. In Mandell GL, Douglas RG, Bennett JE (ed): Principles and practice of infectious diseases. Churchill Livingstone, New York, 1990, p. 670–706.

    Google Scholar 

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Authors and Affiliations

  1. Department of Anaesthesiology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    S. M. H. Nooyen & J. J. M. Langemeyer

  2. Department of Medical Microbiology and Immunology, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    B. P. Overbeek

  3. Department of Cardiopulmonary Surgery, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands

    A. Brutel de la Rivière

  4. Medical Department, Glaxo BV, Zeist, The Netherlands

    A. J. Storm

Authors
  1. S. M. H. Nooyen
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  2. B. P. Overbeek
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  3. A. Brutel de la Rivière
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  4. A. J. Storm
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  5. J. J. M. Langemeyer
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Nooyen, S.M.H., Overbeek, B.P., Brutel de la Rivière, A. et al. Prospective randomised comparison of single-dose versus multiple-dose cefuroxime for prophylaxis in coronary artery bypass grafting. Eur. J. Clin. Microbiol. Infect. Dis. 13, 1033–1037 (1994). https://doi.org/10.1007/BF02111823

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  • DOI: https://doi.org/10.1007/BF02111823

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