A novel protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery under cardiopulmonary bypass

Gen Thorac Cardiovasc Surg. 2015 Aug;63(8):446-52. doi: 10.1007/s11748-015-0552-9. Epub 2015 Apr 30.

Abstract

Objective: This study aimed to develop and assess the effectiveness of a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery.

Methods: We established a protocol for antibiotic prophylaxis based on preoperative kidney function in patients undergoing open heart surgery. This novel protocol was assessed by comparing patients undergoing open heart surgery before (control group; n = 30) and after its implementation (protocol group; n = 31) at Kyoto University Hospital between July 2012 and January 2013.

Results: Surgical site infections (SSIs) were observed in 4 control group patients (13.3 %), whereas no SSIs were observed in the protocol group patients (P < 0.05). The total duration of antibiotic use decreased significantly from 80.7 ± 17.6 h (mean ± SD) in the control group to 55.5 ± 14.9 h in the protocol group (P < 0.05). Similarly, introduction of the protocol significantly decreased the total antibiotic dose used in the perioperative period (P < 0.05). Furthermore, antibiotic regimens were changed under suspicion of infection in 5 of 30 control group patients, whereas none of the protocol group patients required this additional change in the antibiotic regimen (P < 0.05).

Conclusion: Our novel antibiotic prophylaxis protocol based on preoperative kidney function effectively prevents SSIs in patients undergoing open heart surgery.

Publication types

  • Clinical Study
  • Comparative Study

MeSH terms

  • Acute Kidney Injury / etiology
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / administration & dosage*
  • Anti-Bacterial Agents / pharmacokinetics
  • Antibiotic Prophylaxis / methods*
  • Cardiac Surgical Procedures / methods*
  • Cardiopulmonary Bypass / methods*
  • Case-Control Studies
  • Cefazolin / administration & dosage*
  • Cefazolin / pharmacokinetics
  • Clinical Protocols
  • Drug Administration Schedule
  • Female
  • Glomerular Filtration Rate / physiology
  • Humans
  • Injections, Intravenous
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Operative Time
  • Postoperative Complications / etiology
  • Surgical Wound Infection / etiology
  • Surgical Wound Infection / prevention & control*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Cefazolin