Antimicrobial Prophylaxis for Patients Undergoing Cardiac Surgery: Intraoperative Cefazolin Concentrations and Sternal Wound Infections

Antimicrob Agents Chemother. 2018 Oct 24;62(11):e01360-18. doi: 10.1128/AAC.01360-18. Print 2018 Nov.

Abstract

This study characterizes the pharmacodynamics of antimicrobial prophylaxis and sternal wound infections following cardiac surgery. Duration of surgery and cefazolin plasma concentration during wound closure were independently associated with surgical site infection at 30 days. Furthermore, a duration of surgery of >346 min and a total cefazolin closure concentration of <104 mg/liter were significant thresholds for an increased risk of infection. This study provides new data that informs dosing strategies for effective antimicrobial prophylaxis (AP) in patients undergoing cardiac surgery with cardiopulmonary bypass.

Keywords: cardiac surgery; cefazolin; pharmacodynamics; surgical prophylaxis; surgical site infection; wound infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anti-Infective Agents / therapeutic use*
  • Antibiotic Prophylaxis / methods
  • Cardiac Surgical Procedures / adverse effects*
  • Cardiopulmonary Bypass / adverse effects
  • Cefazolin / therapeutic use*
  • Female
  • Humans
  • Male
  • Surgical Wound Infection / microbiology
  • Surgical Wound Infection / prevention & control*
  • Wound Infection / microbiology
  • Wound Infection / prevention & control*

Substances

  • Anti-Infective Agents
  • Cefazolin