Pre-Op Heart Surgery Antibiotics Seemed to Work

Antibiotics before heart surgery reduced surgical site infection risk in new study

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) Before their operations, cardiac surgery patients likely focus on the heart issue at hand. But postoperative infections can cause problems later. Antibiotics might prevent these infections.

A recent study examined the use of antibiotic medications prior to surgery.

The researchers found that cardiac surgery patients who received these preventive medications had a lower risk of surgical site infections than those who did not.

"Wash hands thoroughly when visiting a hospital."

According to the authors of this study, who were led by Renato Finkelstein, MD, of the Rambam Medical Center at the Israel Institute of Technology in Haifa, Israel, surgical site infections (SSIs) can be a serious issue after operations, including cardiac surgeries.

Dr. Finkelstein and team wanted to explore antibiotic prophylaxis, or the preventive use of antibiotics before any infection had occurred, to see if infection risk was reduced.

The researchers followed 2,637 patients who underwent a cardiac operation at Rambam Medical Center from January 1, 1997 to December 31, 2006.

The patients were 73.6 percent male and ranged between the ages of 15 and 91. Patients either received the antibiotic vancomycin (brand name Vancocin) or the antibiotic cefazolin (Ancef).

Overall, 220 patients (8.3 percent) experienced an SSI, including superficial skin infections and deep/organ space infections.

The researchers found that 206 (8.1 percent) of the 2,536 patients who received preoperative antibiotics within two hours of the first incision developed an SSI, compared to 14 (13.9 percent) of the 101 patients who received antibiotics at another time.

The authors of this study noted that while the rate of deeper infections was similar among both groups, those who did not receive preoperative antibiotics were significantly more likely to develop a superficial skin infection.

The rate of these superficial infections was 13.9 percent of those without preoperative antibiotics (14 out of 101 patients) versus 4.8 percent of those who did receive the preoperative antibiotics (121 out of 2,536 patients).

Dr. Finkelstein and team also found more than a 50 percent reduction in SSI rates during the last four years of the study period. The researchers explained that this might be tied to increased compliance with procedures for preoperative antibiotics during this time.

"We observed a progressive and significant decrease in SSI rates after the implementation of an infection control program that included an optimized policy of preoperative prophylaxis in cardiac surgery," these researchers wrote.

This study was published in the January issue of Infection Control and Hospital Epidemiology. No conflicts of interest were reported.

Review Date: 
December 23, 2013
Last Updated:
January 5, 2014