Prospective randomized study of efficacy of 1-day versus 3-day antibiotic prophylaxis for preventing surgical site infection after coronary artery bypass graft

• Published in: Journal of the Formosan Medical Association 2011-10, Vol.110 (10), p.619-626
• Main Authors: Lin, Mei-Hsin, Pan, Sung-Ching, Wang, Jiun-Ling, Hsu, Ron-Bin, Lin Wu, Fei-Lin, Chen, Yee-Chun, Lin, Fang-Yue, Chang, Shan-Chwen
• Format: Article
• Language: English
• Subjects: Aged; Anti-Bacterial Agents - administration & dosage; Antibiotic Prophylaxis; Cefazolin - administration & dosage; coronary artery bypass; Coronary Artery Bypass - adverse effects; Female; Humans; Internal Medicine; Male; Middle Aged; surgical wound infection; Surgical Wound Infection - prevention & control
• ISSN: 0929-6646; 1876-0821
• DOI: 10.1016/j.jfma.2011.08.003

Background/Purpose Despite general recommendation of short-course antibiotic prophylaxis, prolonged antibiotic use is still commonly reported in clinical settings. This study compared the efficacy of 1-day versus 3-day antibiotic prophylaxis in preventing surgical site infection (SSI) in patients undergoing coronary artery bypass graft (CABG). Methods This prospective, randomized control study was performed in a tertiary-care medical center from June 2002 to April 2004. Patients underwent non-emergency CABG and were randomized into two groups receiving either 1 day or 3 days cefazolin prophylaxis. The SSI rates were compared between the two groups. Results During the study period, 231 patients were enrolled, 120 in the 1-day group and 111 in the 3-day group. Twenty-two episodes of SSI were observed within 1 month after operation: 13 (10.8%) in the 1-day group and nine (8.1%) in the 3-day group (odds ratio: 1.37; 95% confidence interval: 0.56–3.33; p  = 0.48). By logistic regression analysis, 1-day prophylaxis with cefazolin was not associated with higher risk of SSI (adjusted odds ratio: 0.91; 95% confidence interval: 0.32–2.56; p  = 0.85). Conclusion Antibiotic prophylaxis for 1 day in CABG surgery was associated with similar rates of postoperative infection compared with antibiotic prophylaxis of 3 days.