Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

Zelenitsky, Sheryl; Calic, Divna; Arora, Rakesh C.; Grocott, Hilary P.; Lakowski, Ted M.; Ryan, L.; Ariano, Robert E.

doi:10.1128/aac.01360-18

Cited by 23 publications

(13 citation statements)

References 14 publications

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“…Previous studies (Sommerstein et al, 2019) have shown that prophylaxis cefazolin administration significantly reduces the incidence of SSIs after CABG surgeries. Further, previous research has demonstrated that administration of cefazolin 30 min before incision with a dose concentration >104 mg/litre at closure time significantly reduces the SSIs after CABG surgeries (Zelenitsky et al, 2018). Since the study is retrospective, it was not possible to assess the antibiotics prophylaxis data accurately.…”

Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman

AlRiyami

AL-Rawajfah

Sabei

et al. 2022

Journal of Infection Prevention

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Background There is limited information about the incidence and risk factors of surgical site infections (SSIs) after coronary artery bypass (CABG) surgeries in the Omani population. Aim To estimate the prevalence and describe possible risk factors of SSIs after CABG surgeries in Oman. Method A retrospective nested case–control design was used to screen 596 patients who underwent CABG surgeries over 2 years (2016–2017) in two tertiary hospitals in Oman. The CDC definition for SSIs was used to identify the infected cases. Results Prevalence rate of SSIs was 17.4% and 17.5% in 2016 and 2017, respectively. The most isolated microorganism was Gram-positive bacteria (45.2%). Risk factors of SSIs include female gender (OR = 3.2, p < 0.001), diabetes (OR = 5.83, p < 0.001), overweight or obese (OR = 2.14, p < 0.05) and shaving technique [using razor shaving] (OR = 8.4, p < 0.001). Readmission rate for the case group was 44.2%. Conclusion The infection rate of SSIs after CABG surgeries in developing countries, such as Oman, is considerably high. There is an urgent need to establish SSIs preventive program at the national level. Frequent and systematic assessment of infection control practices before and after CABG surgeries is fundamental and priority strategy to prevent SSIs.

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Section: Discussionmentioning

confidence: 99%

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman

AlRiyami

AL-Rawajfah

Sabei

et al. 2022

Journal of Infection Prevention

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“…[24][25] It was observed that, in the cardiac surgical ICU, cefazolin was the most widely used antibiotic; the use of cefazolin in cardiac surgery is well documented in the literature, and may have contributed to the consumption found. [26][27] It is worth highlighting the consumption of the latest generation antimicrobial, ceftazidime/avibactam, indicated for the treatment of enterobacteria with multidrug-resistant KPC carbapenemases. Throughout this study, at least one patient used this drug in the studied ICUs, which points to the need for interdisciplinary action between the clinical pharmacy and the SCIH in monitoring the use of this medication, in order to reduce selective pressure and costs.…”

Section: Discussionmentioning

confidence: 99%

Conversion of intravenous to oral antibiotic therapy in an adult intensive care unit

Locatelli¹,

Blatt²,

Werlang³

2020

Rev Bras Farm Hosp Serv Saude

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Objective: To identify the possibility of alteration of intravenous (IV) to oral (PO) therapy for ampicillin/sulbactam and cefuroxime in adult patients treated in intensive care units (ICUs), and to describe the profile and consumption of antimicrobials prescribed for these patients. Methods: A descriptive, cross-sectional, and retrospective documentary study based on the analysis of electronic prescriptions and data from the electronic medical record of patients admitted to adult intensive care units in two hospitals, from July to August 2019. The consumption of antimicrobials was measured using the Anatomical Therapeutic Chemical/Daily Defined Dose (ATC/DDD) methodology per 100 beds-day. Results: Of the patients admitted to the study units, 23 (5.5%) received ampicillin/sulbactam or cefuroxime; the time of the ampicillin/sulbactam treatment was 7.25 (±2.07) days and, with cefuroxime, 8 (±1.73) days; 3 (13%) of the patients followed were eligible to switch therapy or sequential therapy, there was no physician acceptance of the conversion recommendation. The highest consumption was observed in the penicillins therapeutic group (112.5 DDD/100 beds-day) and meropenem drug (68.8 DDD/100 beds-day). Conclusions: Antimicrobial use is high in ICUs, which can be related to the clinical complexity and to the microbiological profile of the patients. The practice of converting IV antibiotic therapy to PO in critically ill patients was not present in this study; however, its use can contribute to patient safety.

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“…Astonishingly, these isoquinoline based compounds (5c, 5d and 5 h) were also showed remarkable bacterial DNA gyrase inhibition and antibacterial activity. [40,41] 0.25-1.0 [42] 0.5 [43,44] 0.5-2.0 [45,46] 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 Analysis of best docking poses of the most potent compounds shows that (one) hydrogen bond and a pi-piinteraction are crucial contributors to binding. The reported correlation of molecular docking and in vitro studies is an exemplary case for the application of this employed in silico tool in order to facilitate drug design and development.…”

Section: Discussionmentioning

confidence: 99%

Computational Approaches to Develop Isoquinoline Based Antibiotics through DNA Gyrase Inhibition Mechanisms Unveiled through Antibacterial Evaluation and Molecular Docking

Muralidharan

Andrew

Ahmed

et al. 2018

Molecular Informatics

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Developing a new antibacterial drug by using (Z/E)-4-(4-substituted-benzylidene)-2-isoquinoline-1,3(2H,4H)-diones (5a-h) via DNA gyrase inhibition mechanism is the main aim of this study. DNA gyrase inhibition assay was executed to confirm the DNA gyrase inhibition potentials of 5a-h. DNA gyrase inhibitory potentials were further validated through molecular docking. Docking study was also intended to get more insight into the binding mode of 5a-h into the active site of DNA gyrase A. Agar well diffusion method antimicrobial activity on Gram bacteria Escherichia coli (MTCC 443), Pseudomonas aeruginosa (MTCC 424), and Gram bacteria (Staphylococcus aureus (MTCC 96) and Streptococcus pyogenes (MTCC 442) was evaluated. Excellent DNA gyrase inhibition was exhibited by the compound 5c, IC 0.55±0.12 μM; 5d, IC 0.65±0.075 μg/mL; 5e, IC 0.45±0.035 μM; 5f, IC 0.58±0.025 μM; 5h, IC 0.25±0.015 μM while Clorobiocin (standard) showed IC 0.5±0.05 μM. Apart from all the in vitro studies, a plausible mechanism of DNA gyrase inhibition was also proposed through the in silico validations that are including molecular docking, predicted SAR, functional group availability, pharmacokinetic, and ADMET properties. These predictions are well supported to confirm the druggability possibility of the most potent compounds among (Z/E)-4-(4-substituted-benzylidene)-2-isoquinoline-1,3(2H,4H) -diones (5a-h).

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Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

Cited by 23 publications

References 14 publications

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman

Incidence and risk factors of surgical site infections after coronary artery bypass grafting surgery in Oman

Conversion of intravenous to oral antibiotic therapy in an adult intensive care unit

Computational Approaches to Develop Isoquinoline Based Antibiotics through DNA Gyrase Inhibition Mechanisms Unveiled through Antibacterial Evaluation and Molecular Docking

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