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oai:uvadoc.uva.es:10324/156192021-06-23T09:50:02Zcom_10324_1133com_10324_931com_10324_894col_10324_1209

Comparative study of single-dose and 24-hour multiple-dose antibiotic prophylaxis for cardiac surgery Tamayo Gómez, Eduardo Gualis, Javier Flórez, Santiago Castrodeza Sanz, José Javier Eiros Bouza, José María Álvarez González, Francisco Javier Cardiovascular, Aparato - Cirugía - Infecciones Producción Científica Use of single-dose antibiotic prophylaxis is associated with reduced antibiotic resistance, lower costs, and fewer problems with drug toxicity and superinfections. We tested the hypothesis that single doses of cefazolin are as effective as a 24-hour regimen of cefazolin in preventing surgical site infections in adults undergoing cardiac procedures. This random, prospective, clinical study included 838 adult patients undergoing elective coronary artery bypass grafting, valve operations, or both. These patients were randomly given a single dose of cefazolin (2 g) or a 24-hour treatment (2-g initial dose, followed by 1 g every 8 hours). Investigators blinded to the drug regimen diagnosed wound infections according to Centers for Disease Control and Prevention criteria. Patient clinical and demographic characteristics were noted, with follow-up for 12 postoperative months. The primary objective was to compare the incidence of surgical infections between groups up to 12 months postoperatively. Results: A total of 419 patients received single-dose cefazolin, and another 419 received the 24-hour treatment. Surgical site infection occurred in 35 (8.3%) patients receiving single doses and 15 (3.6%) patients administered the 24-hour treatment (P ¼ .004). We identified no differences between groups for mortality or duration of hospitalization (preoperative hospitalization, intensive care unit stay, and hospitalization after surgical intervention). The microorganisms isolated showed a similar distribution in both groups. The germs isolated were gram-positive cocci in 86% of the surgical site infections. Single-dose cefazolin used as antibiotic prophylaxis in cardiac surgery is associated with a higher surgical site infection rate than the 24-hour, multiple-dose cefazolin regimen. 2016-01-27T10:06:39Z 2016-01-27T10:06:39Z 2008 info:eu-repo/semantics/article The Journal of Thoracic and Cardiovascular Surgery, 2008; 136( 6 ): 1522-1527 0022-5223 http://uvadoc.uva.es/handle/10324/15619 10.1016/j.jtcvs.2008.05.013 1522 6 1527 The Journal of Thoracic and Cardiovascular Surgery 136 eng info:eu-repo/semantics/openAccess http://creativecommons.org/licenses/by-nc-nd/4.0/ Attribution-NonCommercial-NoDerivatives 4.0 International Elsevier SI