Cefuroxime as antibiotic prophylaxis in coronary artery bypass grafting surgery

Nosocomial-acquired infections remain a serious problem in patients undergoing coronary artery bypass grafting (CABG) surgery. The objective of this retrospective study was to compare the incidence of nosocomial infections in patients undergoing CABG surgery within two periods (1994 and 2003). A single dose of a second generation cephalosporin (cefuroxime) was administered as antibiotic prophylaxis in all patients. There was no statistical significant difference regards to the incidence of hospital-acquired infections between these two periods (4.9% in 1994 and 5.6% in 2003, P=0.62). The most frequent types of postoperative infections were the respiratory tract infection (2.3%) in the first period and the superficial surgical site infection (3.1%) in the second period. The majority of isolated pathogens were Gram-positive cocci (68%) in both periods. The majority of incisional surgical site infections and of central venous catheter-related infections were attributed to Staphylococcus coagulase negative strains. Only one episode of hospital-acquired infection due to a resistant Gram-negative bacterium was recorded during the second period. A single-dose of cefuroxime remains the antibiotic prophylaxis of choice in adult patients submitted to CABG surgery. It is still associated with a low incidence of postoperative infections mainly due to sensitive pathogens.