Unit:
Speciality Infectious DiseasesLibrary of the School of Health Sciences
Supervisors info:
Μήνα Ψυχογυιού, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Ασημίνα Σαφαρίκα, Διδάκτωρ, Ιατρική Σχολή, ΕΚΠΑ
Αντιγόνη Κωτσάκη, Διδάκτωρ, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Αντιμικροβιακή χημειοπροφύλαξη στην καρδιοχειρουργική
Translated title:
Antimicrobial prophylaxis in cardiac surgery
Summary:
Cardiac surgery for the management of coronary disease, valve disease
and aortic dissection is a major and complex procedure, accompanied by the risk of
surgical site infections, which are associated with high morbidity and mortality, with
antimicrobial prophylaxis being an important measure for their prevention.
The evaluation of the effectiveness of antimicrobial prophylaxis in the surgical
site infections reduction in cardio surgery and the investigation of the optimal time of
its administration, duration and optimal dosage.
he sample of the study consisted of 15 primary studies retrieved
based on PRISMA methodology by the data base PubMed.
The incidence of surgical site infections was 5%-17.95%. Cephaloporins and
vancomycin were the most common antibiotics of choice without significant differences
between them regarding the incidence of infections. 2nd and 3rd generation
cephalosporins did not offer any advantage compared with the 1st generation. The
combination of cefalosporin and vancomycin significantly reduces infection incidence
among high-risk patients. The optimal time of initiation was found to be between 16
and 60-minutes prior incision. Continuing antimicrobial prophylaxis during surgery is
necessary. Failure to preserve high plasma concentrations during surgery due to long
gaps between doses increases infection incidence. The optimal initial dosage ranges
between 1-3gr with redosing every 8 hours postoperatively fir 24h. Continuation of
coverage >48 reduces the risk of infection after a surgery of long duration and in highrisk
patients.
Antimicrobial prophylaxis is an effective measure to prevent surgical
site infections in cardiac surgery but should be based on an individualized plan taking
into account the characteristics of the patient, the surgery and the microbial ecology
of the hospital. There is a need for further studies so as to clarify the optimal duration
of antimicrobial prophylaxis.
Main subject category:
Health Sciences
Keywords:
Infections, Cardiac surgery, Antimicrobial prophylaxis
Number of references:
113
