Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery

Movahed, Mohammad Reza; Kasravi, Babak; Bryan, Charles S.

doi:10.1177/107424840400900i103

Cited by 13 publications

(5 citation statements)

References 90 publications

(88 reference statements)

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“…Less than 80 years after their introduction in 1935, antibiotics evolved from the ultimate weapon against the primary causes of morbidity and mortality to a significant surgical risk factor. Antibiotic overuse has been responsible for the development of bacteria that resist eradication 8 . Undergoing surgery has been shown to increase a hospitalized patient's risk of acquiring an antibiotic‐resistant infection by 62% 9 .…”

Section: Behavioral Objectivesmentioning

confidence: 99%

Wise use of perioperative antibiotics

Plonczynski

2005

AORN Journal

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NOSOCOMIAL SURGICAL SITE INFECTIONS (SSIs), especially those caused by antibiotic-resistant organisms, are a major concern for perioperative nurses. Administering the correct antibiotic at its effective dose within the optimal time frame can help prevent SSIs. THE SIGNIFICANT RELATIONSHIP between microbial resistance and overuse of antibiotics justifies an examination of practices and a move away from widespread antibiotic administration. NEW ANTIBIOTIC GUIDELINES and research support recommendations for antibiotic administration for specific cardiac, colorectal, gynecologic, ophthalmologic, orthopedic, and urinary surgical procedures. Perioperative nurses can help protect their patients from nosocomial SSIs by using this clinical evidence.

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Section: Behavioral Objectivesmentioning

confidence: 99%

Wise use of perioperative antibiotics

Plonczynski

2005

AORN Journal

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“…To prevent biomaterial-associated infections, antibiotic prophylaxis is recommended for various medical conditions requiring biomaterial implants (15,23), but a major concern is the development of resistance (32,35,37). Therefore, new strategies for prophylaxis or treatment of biomaterial-associated infections are required.…”

mentioning

confidence: 99%

Treatment and Prevention of Staphylococcus epidermidis Experimental Biomaterial-Associated Infection by Bactericidal Peptide 2

Kwakman

Velde

Vandenbroucke-Grauls

et al. 2006

Antimicrob Agents Chemother

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Biomaterial-associated infections (BAI) are the major cause of failure of indwelling medical devices and are predominantly caused by staphylococci, especially Staphylococcus epidermidis. We investigated the in vitro microbicidal activity of the synthetic antimicrobial peptide bactericidal peptide 2 (BP2) and its efficacy in a murine model of S. epidermidis BAI. BP2 showed potent microbicidal activity at micromolar concentrations against a broad spectrum of microorganisms, including antibiotic-resistant bacteria. The staphylocidal activity of BP2 was not affected by physiological salt concentrations and was only slightly affected by the presence of human plasma. In the BAI model, injection of BP2 (5 mg/kg of body weight) 1 h after challenge with S. epidermidis resulted in an 80% reduction in the number of culture-positive implants and a 100-fold reduction in survival of S. epidermidis in peri-implant tissue at 24 h postchallenge. When BP2 was injected along implants 3 h prior to bacterial challenge, the median numbers of CFU cultured from biomaterial implants and peri-implant tissue were reduced by 85% and 90%, respectively. In conclusion, BP2 has potent, broad-spectrum in vitro microbicidal activity and showed potent in vivo activity in a murine model of S. epidermidis biomaterialassociated infection.

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“…It has been traditionally used as a prophylactic agent in centers with a high incidence of MRSA or as an alternative agent in type 1 penicillin-allergic patients undergoing cardiac surgery. 8 The results of this study indicate that the twice-dosing regimen of vancomycin intraoperatively (1 g during induction and 500 mg after CPB) resulted in serum concentrations above the MIC for most common pathogenic organisms (≥2 mg/mL) in all 34 patients. In Vuorisalo's report, 9 10 patients received 3 doses of vancomycin: 1 g prior to induction of anesthesia, 0.5 g 1 hour after onset of CPB, and a final 1 g 12 hours after the first dose.…”

Section: Discussionmentioning

confidence: 68%

The Efficacy of Post-Cardiopulmonary Bypass Dosing of Vancomycin in Cardiac Surgery

Raikhelkar

Reich

Schure

et al. 2010

Semin Cardiothorac Vasc Anesth

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Objective. Vancomycin is administered widely to patients undergoing cardiac surgery as prophylaxis against resistant Gram-positive sternal wound and venous donor site infections. The purpose of this study was to determine the efficacy of a standardized prebypass and postbypass dosing regimen of vancomycin by assessing plasma concentrations in the immediate postoperative period and postoperative surgical site infections (SSIs). Design. Retrospective cohort study. Setting . Cardiothoracic surgical intensive care unit in a tertiary care academic medical center. Methods. A total of 34 consecutive adult patients who had undergone cardiac surgery with cardiopulmonary bypass (CPB) were analyzed retrospectively. Each patient received 1000 mg of vancomycin administered over 1 hour around the time of induction of anesthesia and 500 mg after discontinuation of CPB. Trough vancomycin levels were sampled in the intensive care unit 12 hours after the last dose given in the operating room. Along with patient characteristics, postoperative readmission rates and SSIs were recorded for 1 year after surgery. Results. The nadir serum vancomycin level before the next dose was 9.3 ± 4.5 µg/mL (mean ± standard deviation). One superficial SSI was noted. Readmission rate for SSIs was 2.94%. Conclusion . Vancomycin concentrations in the serum were greater than the minimum inhibitory concentration for most staphylococci ranging from 4 to 19.3 µg/mL producing acceptable therapeutic serum concentrations and low rate of infectious complications. Thus postbypass dosing is acceptable in vancomycin cardiac surgical prophylaxis.

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Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery

Cited by 13 publications

References 90 publications

Wise use of perioperative antibiotics

Wise use of perioperative antibiotics

Treatment and Prevention of Staphylococcus epidermidis Experimental Biomaterial-Associated Infection by Bactericidal Peptide 2

The Efficacy of Post-Cardiopulmonary Bypass Dosing of Vancomycin in Cardiac Surgery

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