Antibiotic Prophylaxis for Cardiovascular Surgery

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Abstract
Patients (220) were randomly assigned to receive either ceforanide or cephalothin as perioperative antibiotic prophylaxis during cardiovascular surgery. More infections were seen among cephalothin recipients (8 deep, 32 total) than among ceforanide recipients (1 deep, 17 total). Among patients who had only coronary artery bypass grafting, more cephalothin recipients had infection than did ceforanide recipients (19 of 82 as opposed to 7 of 83; P = 0.001; relative risk, 2.7; 95% confidence interval, 1.22-6.18). The diference between the 2 regimens was attributable to fewer blood, wound and urinary tract infections. Among patients who had other procedures, there was no difference in the efficacy of the 2 regimens. Cephalothin recipients who developed wound or blood stream infections had lower antibiotic levels in their atrial appendages than recipients not developing such infections (P = 0.02). If one assumes that cephalothin does not increase the risk of infection, then these data show that antibiotic prophylaxis prevents infection after coronary artery bypass surgery. In the dosages used, ceforanide was superior to cephalothin.