Antibiotic prophylaxis in cardiac surgery

A prospective, randomised study was conducted among 1009 cardiac surgery patients in order to compare the prophylactic efficacy of a second generation cephalosporin (cefuroxime) given as single shot, versus a broad spectrum double regimen (amoxycillin-netilmicin).

Cefuroxime received 501 patients (Group A), while a 4-day combination of amoxycillin-netilimicin 508 patients (Group B).

There were found no statistically significant differences either in infection rate or the kind of infection between the two groups. Single shot cefuroxime prophylaxis was just as effective, as a 4-day combination of amoxycillin and netilmicin. Total infection rate was 5.6% (n=28) in Group A and 5.7% (n=29) in Group B. Respiratory tract infection was the most frequently registered in both groups; 2.6% in Group A and 2.9% in Group B. Sternal wound and catheter-related infection rates were 0.6% and 1% in both groups, respectively. There were no side effects due to the given antibiotics.

A single shot of cefuroxime prophylaxis is equally effective and safe as a 4-day regimen with amoxycillin and netilmicin.