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Single-dose antimicrobial prophylaxis in open heart surgery.

T Beam, T Raab, J Spooner

European Journal of Clinical Microbiology

|December 1, 1984

Summary

A single dose of ceftriaxone effectively prevented infections after heart surgery, matching cefazolin

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Area of Science:

Infectious Disease
Cardiovascular Surgery
Pharmacology

Background:

Surgical site infections are a significant risk following coronary artery bypass graft (CABG) surgery.
Current prophylactic antibiotic regimens often involve multiple doses, increasing complexity and cost.
Ceftriaxone and cefazolin are commonly used antibiotics for surgical prophylaxis.

Purpose of the Study:

To compare the efficacy and safety of a single pre-operative dose of ceftriaxone versus multiple peri-operative doses of cefazolin for preventing infections in CABG surgery.

Main Methods:

A comparative study involving 94 evaluable patients undergoing CABG surgery.
Patients were randomized to receive either a single 1-gram dose of ceftriaxone or seven 1-gram doses of cefazolin.
Infectious complications were monitored and compared between the two treatment groups.

Main Results:

No statistically significant difference was observed in the incidence of infectious complications between the ceftriaxone and cefazolin groups.
Ceftriaxone demonstrated a long terminal half-life of approximately 15.7 hours.
Neither antibiotic regimen exhibited significant toxicity.

Conclusions:

Single-dose pre-operative ceftriaxone is an effective prophylactic strategy for preventing infections in open-heart surgery.
This single-dose approach offers potential for considerable cost savings due to reduced antibiotic administration.
Ceftriaxone represents a viable and potentially more economical alternative for surgical prophylaxis in CABG procedures.

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