• Infect Control Hosp Epidemiol · Apr 1998

    Randomized Controlled Trial Comparative Study Clinical Trial

    Comparison of vancomycin and cefuroxime for infection prophylaxis in coronary artery bypass surgery.

    • S Vuorisalo, R Pokela, and H Syrjälä.
    • Department of Surgery, University of Oulu, Finland. Sailaritta.Vuorisalo@fimnet.fi
    • Infect Control Hosp Epidemiol. 1998 Apr 1;19(4):234-9.

    ObjectiveTo investigate clinically significant differences between vancomycin and cefuroxime for perioperative infection prophylaxis in coronary artery bypass surgery.DesignA total of 884 patients were randomized prospectively to receive either cefuroxime (444) or vancomycin (440) and were assessed for infectious complications during hospitalization and 1 month postoperatively.SettingA university hospital.ResultsThe 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).ConclusionsThe 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.

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