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Published on: June 23, 2020
Comparison of vancomycin and cefuroxime for infection prophylaxis in coronary artery bypass surgery
S Vuorisalo1, R Pokela, H Syrjälä
1Department of Surgery, University of Oulu, Finland. Sailaritta.Vuorisalo@fimnet.fi
Objective:
To investigate clinically significant differences between vancomycin and cefuroxime for perioperative infection prophylaxis in coronary artery bypass surgery.
Design:
A total of 884 patients were randomized prospectively to receive either cefuroxime (444) or vancomycin (440) and were assessed for infectious complications during hospitalization and 1 month postoperatively.
Setting:
A university hospital.
Results:
The overall immediate surgical-site infection rate was 3.2% in the cefuroxime group and 3.5% in the vancomycin group (difference, -0.3; 95% confidence interval, -2.6-2.1).
Conclusions:
The data suggest that vancomycin has no clinically significant advantages over cephalosporin in terms of antimicrobial prophylaxis. We suggest that cefuroxime (or first-generation cephalosporins, which were not studied here) is a good choice for infection prophylaxis in connection with coronary artery bypass surgery in institutions without methicillin-resistant Staphylococcus aureus problems. In addition to the increasing vancomycin-resistant enterococci problem, the easier administration and usually lower price of cefuroxime make it preferable to vancomycin.
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