Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime

Bradley Doebbeling, M. A. Pfaller, K. R. Kuhns, R. M. Massanari, D. M. Behrendt, R. P. Wenzel

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

A prospective double-blind trial was performed at a tertiary care center to evaluate perioperative cephalosporin prophylaxis in cardiac operations. Patients were randomized to receive either cefazolin (n = 104) or cefuroxime (n = 109), the preoperative dose being given within 1 hour before the initial incision. Drugs were continued for 48 hours (cefazolin, 1 gm intravenously every 8 hours; cefuroxime, 1.5 gm intravenously every 12 hours). Postoperative infections were assessed by trained nurse clinicians, and data were analyzed by the intention-to-treat principle. Sternal wound infections or mediastinitis occurred in one of 104 patients treated with cefazolin and 10 of 109 treated with cefuroxime (p = 0.01). Deep sternal wounds (including mediastinitis and sternal osteomyelitis) occurred in none of the cefazolin-treated patients and five cefuroxime-treated patients (p = 0.06). Although overall nosocomial infection rates were similar (16.3 versus 19.3 per 100), wound infection occurred somewhat more frequently with streptococci (groups B and D) in patients receiving cefazolin (four versus zero, p = 0.110); conversely staphylococcal infections were more frequent in the cefuroxime group (seven versus one, p = 0.066). Mean and median postoperative stay was 1 day shorter in the cefazolin group. In contrast to findings of a previous report, our data indicate that cefazolin prevented more sternal wound infections than cefuroxime, a finding that supports prophylaxis with a first-generation cephalosporin.

Original languageEnglish (US)
Pages (from-to)981-989
Number of pages9
JournalJournal of Thoracic and Cardiovascular Surgery
Volume99
Issue number6
StatePublished - 1990
Externally publishedYes

Fingerprint

Cefazolin
Cefuroxime
Wound Infection
Mediastinitis
Cephalosporins
Nurse Clinicians
Staphylococcal Infections
Streptococcus agalactiae
Enterococcus faecalis
Osteomyelitis
Cross Infection
Tertiary Care Centers
Wounds and Injuries
Infection
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Doebbeling, B., Pfaller, M. A., Kuhns, K. R., Massanari, R. M., Behrendt, D. M., & Wenzel, R. P. (1990). Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime. Journal of Thoracic and Cardiovascular Surgery, 99(6), 981-989.

Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime. / Doebbeling, Bradley; Pfaller, M. A.; Kuhns, K. R.; Massanari, R. M.; Behrendt, D. M.; Wenzel, R. P.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 99, No. 6, 1990, p. 981-989.

Research output: Contribution to journalArticle

Doebbeling, B, Pfaller, MA, Kuhns, KR, Massanari, RM, Behrendt, DM & Wenzel, RP 1990, 'Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime', Journal of Thoracic and Cardiovascular Surgery, vol. 99, no. 6, pp. 981-989.
Doebbeling, Bradley ; Pfaller, M. A. ; Kuhns, K. R. ; Massanari, R. M. ; Behrendt, D. M. ; Wenzel, R. P. / Cardiovascular surgery prophylaxis. A randomized, controlled comparison of cefazolin and cefuroxime. In: Journal of Thoracic and Cardiovascular Surgery. 1990 ; Vol. 99, No. 6. pp. 981-989.
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