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Prophylactic antibiotics prior to bacteremia decrease endovascular graft infection in dogs.

Lee Kirksey1, Bruce J Brener, Steven Hertz

  • 1Department of Surgery, Newark Beth Israel Medical Center, Newark, NJ 07112, USA. Lkirksey@SBHCS.com

Vascular and Endovascular Surgery
|June 21, 2002
PubMed
Summary
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Prophylactic antibiotics may prevent stent graft infections. In a canine model, early antibiotic use after stent graft placement reduced Staphylococcus aureus infections, suggesting a benefit during the critical early postoperative period.

Area of Science:

  • Vascular Surgery
  • Infectious Disease
  • Biomedical Engineering

Background:

  • Endovascular stent grafts are widely used but susceptible to infection.
  • No established guidelines exist for prophylactic antibiotics to prevent stent graft infections.

Purpose of the Study:

  • To evaluate the efficacy of prophylactic antibiotics in preventing stent graft infections.
  • To determine the optimal timing for antibiotic administration to prevent bacterial seeding.

Main Methods:

  • A canine model was used with stent graft implantation in the iliac artery.
  • Groups received Staphylococcus aureus challenge at 1 or 7 days post-implantation, with or without cefazolin prophylaxis.
  • Stent graft complexes were cultured for S. aureus.

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Main Results:

  • Stent graft infection was consistently reproducible in the canine model.
  • Early antibiotic prophylaxis (1 day post-implantation) significantly reduced S. aureus colonization.
  • Grafts implanted 7 days prior to bacterial challenge showed reduced susceptibility to infection.

Conclusions:

  • Prophylactic antibiotics are recommended in the early postoperative period to prevent endovascular stent graft infections.
  • The formation of pseudointima may contribute to reduced infection susceptibility over time.
  • This study establishes a reliable model for investigating stent graft infections.