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

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

Author information

1
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada zelenits@umanitoba.ca.
2
Department of Pharmacy, St. Boniface Hospital, Winnipeg, Manitoba, Canada.
3
College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
4
Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
5
Cardiac Sciences Program, St. Boniface Hospital, Winnipeg, Manitoba, Canada.
6
Pharmaceutical Analysis Laboratory, College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.

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

PMID:
30150469
PMCID:
PMC6201110
[Available on 2019-04-24]
DOI:
10.1128/AAC.01360-18

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