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Comparison of Vancomycin and Cefuroxime for Infection Prophylaxis in Coronary Artery Bypass Surgery

Published online by Cambridge University Press:  02 January 2015

Sailaritta Vuorisalo ,
Risto Pokela  and
Hannu Syrjälä
Sailaritta Vuorisalo*
Affiliation:
Department of Surgery, University of Oulu
Risto Pokela
Affiliation:
Department of Surgery, University of Oulu
Hannu Syrjälä
Affiliation:
Department of Infection Control, Oulu University Hospital, Oulu, Finland
*
Department of Surgery, Central Hospital of Pori, Sairaalantie 3, FIN-28500 PORI, Finland; e-mail:, Sailaritta.Vuorisalo@fimnet.fi.
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Abstract

OBJECTIVE: To investigate clinically significant differences between vancomycin and cefuroxime for perioperative infection prophylaxis in coronary artery bypass surgery.

DESIGN: A total of 884 patients were randomized prospectively to receive either cefuroxime (444) or van-comycin (440) and were assessed for infectious complications during hospitalization and 1 month postoperatively.

SETTING: A university hospital.

RESULTS: The overall immediate surgical-site infection rate was 3.2% in the cefuroxime group and 3.5% in the vancomycin group (difference, −0.3; 95% confidence interval, −2.6-2.1).

CONCLUSIONS: The data suggest that vancomycin has no clinically significant advantages over cephalosporin in terms of antimicrobial prophylaxis. We suggest that cefuroxime (or first-generation cephalosporins, which were not studied here) is a good choice for infection prophylaxis in connection with coronary artery bypass surgery in institutions without methicillin-resistant Staphylococcus aureus problems. In addition to the increasing vancomycin-resistant enterococci problem, the easier administration and usually lower price of cefuroxime make it preferable to vancomycin.

Type
Research Article
Information
Infection Control & Hospital Epidemiology , Volume 19 , Issue 4 , April 1998 , pp. 234 - 239
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1998

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