Abstract

VARGAS-GARCIA, ALBERTO RAFAEL  and  GONZALEZ-PEREZ, JAVIER MAURICIO. A comparative study of Cefuroxime versus Cefazolin as prophylaxis in cardiovascular surgery. CES Med. [online]. 2015, vol.29, n.1, pp.75-87. ISSN 0120-8705.

Introduction: Surgical site infection increases morbidity and mortality, use of antibiotic, bacterial resistance and healthcare costs. Aim: to compare the incidence of surgical site infection in patients undergoing cardiac surgery with cefuroxime for 24 hours versus cefazolin for 48 hours. Methods: Historical cohort of a convenience sample of 448 adult patients undergoing valve replacement surgery, coronary bypass surgery or mixed. Endogenous risk factors were: age, sex, weight, BMI, diabetes, COPD, smoking and exogenous factors: type of surgery, aortic campling time and perfusion, temperature of hypothermia, length hospital stay, blood transfusion, reintervention. Qualitative variables were presented with absolute and relative frequencies, quantitative variables with measures of central tendency, dispersion and position. Differences in proportions were compare with Chi square and Fisher exact test; further to this the RR was calculated and statistical significance was assumed at p <0.05. Results: infection incidence in cefazolin group was 8,7 % and 7,9 % in cefuroxime group (p=0,73). Associated variables to surgical site infection were: Intraoperative blood transfusion RR=6,5; dyslipidemia RR=2,94; smoking RR=3,3; diabetes RR=2,9; reoperation RR=3,9. Swan-Ganz catheter was introduced as potential confounder. Conclusion: There was no difference in the incidence of surgical site infection between cefazolin 48 hours versus cefuroxime for 48 hours in cardiac surgery.

Keywords : Infection; Antibiotic prophylaxis; Thoracic surgery.

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