Smh. Nooyen et al., PROSPECTIVE RANDOMIZED COMPARISON OF SINGLE-DOSE VERSUS MULTIPLE-DOSECEFUROXIME FOR PROPHYLAXIS IN CORONARY-ARTERY BYPASS-GRAFTING, European journal of clinical microbiology & infectious diseases, 13(12), 1994, pp. 1033-1037
To assess the efficacy of single-dose antibiotic prophylaxis in corona
ry artery bypass grafting, 1,016 consecutive patients were prospective
ly randomized to receive either a single dose or a three-day course of
cefuroxime. Nine patients (0.9%) died within seven days; no death was
caused by infection. For various reasons 163 other patients were not
evaluable. Therefore, 844 patients were evaluated. Patients in group A
(n = 419) received 20 mg/kg cefuroxime intravenously at induction of
anaesthesia; group B (n = 425) received the same dose followed by 750
mg t.i.d. for three consecutive days. Both groups were comparable rega
rding all risk factors. The efficacy of the prophylactic regimens was
evaluated by comparison of occurrence of wound infection in both group
s. No significant differences in wound infection were observed between
the two treatment groups: sternal site infection in the single-dose p
rophylaxis group was 14% versus 13% in the three-day course group; don
or site infection occurred in 38% versus 39%. It is concluded that in
coronary artery bypass grafting a single dose of cefuroxime is as effe
ctive as a three-day course in the prevention of wound infection.