Comparative study of single-dose and 24-hour multiple-dose antibiotic prophylaxis for cardiac surgery

Tamayo, Eduardo; Gualis, Javier; Flórez, Santiago; Castrodeza, Javier; Bouza, José Marı́a Eiros; Álvarez, Francisco

doi:10.1016/j.jtcvs.2008.05.013

Cited by 56 publications

(37 citation statements)

References 29 publications

(67 reference statements)

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“…That significant difference was due to the significantly higher single dose SSWI rate (5%) than with multiple doses (1.7%) (p = 0.007). Notably, DSWI and endocarditis rates were comparable for both groups (respectively 1.9% and 1.2% for single dose vs. 1.2% and 0.2% with 24-h regimen) comparable to those of current study [9].…”

Section: Discussionsupporting

confidence: 79%

“…A recent systematic review and meta-analysis showed that perioperative antibiotic prophylaxis lasting ≥24 hours might be more effective than shorter regimen but the findings were limited by the heterogeneity of antibiotic regimens and the risk of bias in the published studies [1]. Some studies compared single-dose vs longer antibiotic prophylaxis [1], but very few used the same antibiotic in both arms [8,9] and only the former compared singledose vs 24-hour doses of the same antibiotic. Tamayo and associates, in their monocentric unblinded prospective study, compared 2 cefazolin doses over 42 months: the single-dose was associated with significantly higher SSI rate (8.3%) than with multiple-doses (3.6%) (p = 0.004).…”

Section: Discussionmentioning

confidence: 99%

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Intraoperative vs 24-Hour Administration of Cefamandole to Prevent Deep Sternal Wound Infection and Endocarditis after Adult Cardiac Surgery

Maillet¹,

Thierry²,

Oghina³

et al. 2013

OJAnes

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Background and Objectives: Duration of antibiotic prophylaxis for cardiac surgery is still debated and controversial. International guidelines are vague: French guidelines recommend an intraoperative administration, while the Society of Thoracic Surgeons' guidelines suggest that optimal postoperative prophylactic antibiotics be given for 48 hours or less. Very few studies have compared the same antibiotic with 2 different administration durations. The study was designed to compare the efficacy of 24-hour administration of cefamandole vs intraoperative cefamandole to prevent deep sternal wound infection and endocarditis after cardiac surgery. Methods: This retrospective and observational study compared the rates of severe surgical site infections (deep sternal wound infection, endocarditis) after cardiac surgery between period 1, 01/01/2008-31/08/2008, with 24-hour administration of cefamandole, and period 2, 01/09/2008-30/04/2009 with intraoperative cefamandole. Results: Among 933 patients, 14 patients (1.5%) developed surgical site infection during the 16-month study: 1.3% during the first period and 1.7% during the second (ns). The populations (470 patients in period 1 and 463 in period 2) were homogeneous and comparable for pre-, intra-and postoperative characteristics. Surgical site infection characteristics (pathogens involved, time to diagnosis) and consequences (longer hospital stay, outcomes) were comparable in the 2 groups. Conclusions: Intraoperative cefamandole was as safe as its 24-hour administration to prevent deep sternal wound infection and endocarditis after adult cardiac surgery.

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Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Intraoperative vs 24-Hour Administration of Cefamandole to Prevent Deep Sternal Wound Infection and Endocarditis after Adult Cardiac Surgery

Maillet¹,

Thierry²,

Oghina³

et al. 2013

OJAnes

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“…Of the patients admitted to intensive care units (ICUs), the incidence of severe sepsis or septic shock is between 9% and 37% [1][2][3][4]. In spite of recent advances in treatment with antibiotics and critical care therapy, sepsis still results in a high mortality rate; it is typically between 40% and 60% in the case of septic shock [1][2][3][4][5]. Septic shock and multiple organ dysfunction syndrome (MODS) are the most common causes of death in ICUs [4].…”

Section: Introductionmentioning

confidence: 99%

Evolution of neutrophil apoptosis in septic shock survivors and nonsurvivors

Tamayo

Gómez

Bustamante

et al. 2012

Journal of Critical Care

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Purpose:The aims were to analyze the temporal evolution of neutrophil apoptosis, to determine the differences in neutrophil apoptosis among 28-day survivors and nonsurvivors, and to evaluate the use of neutrophil apoptosis as a predictor of mortality in patients with septic shock. Materials and Methods: Prospective multicenter observational study carried out between July 2006 and June 2009. The staining solution study included 80 patients with septic shock and 25 healthy volunteers. Neutrophil apoptosis was assessed by fluorescein isothiocyanate (FITC)-conjugated annexin V and aminoactinomycin D staining. Results: The percentage of neutrophil apoptosis was significantly decreased at 24 hours, 5 days, and 12 days after the diagnosis of septic shock (14.8% ± 13.4%, 13.4% ± 8.4%, and 15.4% ± 12.8%, respectively; P b .0001) compared with the control group (37.6% ± 12.8%). The difference in apoptosis between 28-day surviving and nonsurviving patients was nonsignificant (P N .05). The mortality rate at 28 days was 53.7%. Journal of Critical Care (2012) 27, 415.e1-415.e11 The crude hazard ratio for mortality in patients with septic shock did not differ according to the percentage of apoptosis (hazard ratio, 1.006; 95% confidence interval, 0.98-1.03; P = .60). Conclusions: During the first 12 days of septic shock development, the level of neutrophil apoptosis decreases and does not recover normal values. No differences were observed between surviving and nonsurviving patients.

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“…At the same time, inhospital patients are also at risk for multiple postoperative events (eg, myocardial infarction [MI], congestive heart failure, acute renal failure, strokes) [1][2][3][4]16,18,19]. These comorbidities complicate the evaluation of the impact of VAP on mortality [17].…”

Section: Introductionmentioning

confidence: 99%

Ventilator-associated pneumonia is an important risk factor for mortality after major cardiac surgery

Tamayo

Álvarez

Martínez-Rafael

et al. 2012

Journal of Critical Care

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Purpose: Ventilator-associated pneumonia (VAP) is the main infectious complication in cardiac surgery patients and is associated with an important increase in morbidity and mortality. The aim of our study was to analyze the impact of VAP on mortality excluding other comorbidities and to study its etiology and the risk factors for its development. Materials and Methods: This prospective cohort study included 1610 postoperative cardiac surgery patients' status post cardiopulmonary bypass (CPB)

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Comparative study of single-dose and 24-hour multiple-dose antibiotic prophylaxis for cardiac surgery

Abstract: 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.

Cited by 56 publications

References 29 publications

Intraoperative vs 24-Hour Administration of Cefamandole to Prevent Deep Sternal Wound Infection and Endocarditis after Adult Cardiac Surgery

Intraoperative vs 24-Hour Administration of Cefamandole to Prevent Deep Sternal Wound Infection and Endocarditis after Adult Cardiac Surgery

Evolution of neutrophil apoptosis in septic shock survivors and nonsurvivors

Ventilator-associated pneumonia is an important risk factor for mortality after major cardiac surgery

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