- Meeting abstract
- Open Access
Antibiotic Usage in First Time Coronary Artery Surgery
© Heaney and Trenfield 2015
- Published: 16 December 2015
- Coronary Artery Bypass Grafting
- Nosocomial Infection
- Clostridium Difficile
Prophylactic antibiotics have an important role in the prevention of infection following cardiac surgery , however, inappropriate or excessive use is associated with the development of antibiotic resistance Cephalosporins, for example, have a well-established association with clostridium difficile . The incidence of nosocomial infections in patients who undergo coronary artery bypass grafting (CABG) is approximately 5% . The current antibiotic regimen for patients who undergo CABG at the Royal Brompton Hospital (RBH) includes cefuroxime 1500 mg at induction and 750 mg prior to sternal closure, followed by two further doses of 750 mg postoperatively, eight hours apart. We conducted a retrospective audit to evaluate adherence to the trust's prescribing guideline for CABG and to review the use of antibiotics in the postoperative period.
Patients who underwent first-time CABG from 01.08.2014 to 31.10.2014 were eligible for inclusion. Data were retrospectively collected from the anaesthetic record, the electronic patient record and the medical notes. Data collected included details of antibiotic usage: choice of antibiotic, timing and duration of administration.
Antibiotic usage for CABG at RBH.
Correct antibiotic at induction
Antibiotics within 60 minutes of incision
Second dose prior to sternal closure
Correct postoperative doses
Second-line antibiotics commenced
13 (42%) of the 31 patients who received additional antibiotics had some form of positive microbiology, whereas 9 of these patients (29%) had no microbiology analysis. Documentation of the indication for additional antibiotics was only identified for 19 patients (61%).
This audit found excessive, prolonged use of antibiotics post CABG at RBH. Documentation of the indication for antibiotics was poor.
- Edwards FH, Engelman RM, Houck P, et al: The Society of Thoracic Surgeons Practice Guideline Series: Antibiotic Prophylaxis in Cardiac Surgery, Part I: Duration. Ann Thorac Surg. 2006, 81: 397-404.View ArticlePubMedGoogle Scholar
- Harbarth S, Samore MH, Lichtenberg D, et al: Prolonged Antibiotic Prophylaxis After Cardiovascular Surgery and Its Effect on Surgical Site Infections and Antimicrobial Resistance. Circulation. 2000, 101: 2916-2921.View ArticlePubMedGoogle Scholar
- Gupta A, Hote MP, Choudhury M, et al: Comparison of 48 h and 72 h of prophylactic antibiotic therapy in adult cardiac surgery: a randomized double blind controlled trial. J Antimicrob Chemother. 2010, 65: 1036-41.View ArticlePubMedGoogle Scholar
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