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Clinical, Microbiological, and Economic Benefit of a Change in Antibiotic Prophylaxis for Cardiac Surgery

Published online by Cambridge University Press:  02 January 2015

Denis Spelman*
Affiliation:
Infection Control and Hospital Epidemiology Unit, Alfred Hospital, Prahran, Victoria, Australia
Glenys Harrington
Affiliation:
Infection Control and Hospital Epidemiology Unit, Alfred Hospital, Prahran, Victoria, Australia
Phil Russo
Affiliation:
Infection Control and Hospital Epidemiology Unit, Alfred Hospital, Prahran, Victoria, Australia
S. Wesselingh
Affiliation:
Infection Control and Hospital Epidemiology Unit, Alfred Hospital, Prahran, Victoria, Australia
*
Microbiology, Alfred Hospital, Commercial Road, Prahran 3181, Australia

Abstract

Vancomycin and rifampicin replaced cephazolin as antibiotic prophylaxis for coronary artery bypass surgery at our institution. Following this intervention, there was a significant decrease (P < .001) in the surgical-site infection rate from 10.5 (95% confidence interval, 8.2 to 13.3) to 4.9 (95% confidence interval, 3.2 to 7.1) infections per 100 procedures. An estimated $576,655 (Australian) was saved between two 12-month periods.

Type
Concise Communications
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Kreter, B, Woods, M. Antibiotic prophylaxis for cardiothoracic operations. Thorac Cardiovasc Surg 1992;104:590599.CrossRefGoogle ScholarPubMed
2.Gilbert, DN, Moellering, RC, Sande, MA, eds. Sanford Guide to Antimicrobial Therapy. Hyde Park, VT: Antimicrobial Therapy Inc.; 2000. Table 15B.Google Scholar
3.Spicer, J, Christiansen, K, Currie, B, et al. Therapeutic Guidelines: Antibiotic Version 11. Victoria, Australia: Therapeutic Guidelines Limited; 2000.Google Scholar
4.Horan, TC, Gaynes, RP, Martone, WJ, et al. CDC definitions of surgical site infection, 1992: a modification of CDC definitions of surgical site infections. Infect Control Hosp Epidemiol 1992;13:606608.Google Scholar
5.Spelman, DW, Russo, P, Harrington, G, et al. Risk factors for surgical wound infection and bacteremia following coronary artery bypass surgery. Aust N Z J Surg 2000;70:4551.CrossRefGoogle ScholarPubMed
6.Jenney, AW, Harrington, GA, Russo, PI, Spelman, DW. The cost of surgical site infections following coronary artery bypass graft surgery. Aust N Z J Surg 2001;71:662664.Google Scholar
7.Maki, DG, Bolin, MJ, Stolz, SM, Kroncke, GM, Archer, CW, Myerowitz, PD. Comparative study of cefazolin, cefamandole and vancomycin for surgical prophylaxis in cardiac and vascular operations. J Thorac Cardiovasc Surg 1992;104:14231434.Google Scholar
8.Vuorisalo, S, Pokala, K, Syrjala, H. Comparison of vancomycin and cefuroxime for infection prophylaxis in coronary artery bypass surgery. Infect Control Hosp Epidemiol 1998;19:234239.Google Scholar
9.Archer, GL, Armstrong, BC, Kline, BJ. Rifampicin blood and tissue levels in patients undergoing cardiac valve surgery. Antimicrob Agents Chemother 1992;21:800803.Google Scholar
10.Tornieporth, NG, Roberts, RB, John, J, Hafner, A, Riley, LW. Risk factors associated with vancomycin-resistant Enterococcus faecium infection or colonization in 145 matched case patients and control patients. Clin Infect Dis 1996;23:767772.Google Scholar