JAC Advance Access originally published online on October 16, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 877-879
© 2003 The British Society for Antimicrobial Chemotherapy
Effect of extended perioperative antibiotic prophylaxis on intravascular catheter colonization and infection in cardiothoracic surgery patients
Departments of 1 Microbiology and 2 Cardiothoracic Surgery, Leeds Teaching Hospitals and University of Leeds, Leeds, UK
Received 4 November 2002; returned 31 December 2002, revised 4 February 2003; accepted 13 August 2003
Intravascular catheter-related infections (CRI) account for one third of nosocomial bloodstream infections in England. UK Department of Health guidelines state that antibiotic prophylaxis is not required during placement, or use of, central venous catheters, to prevent CRI. However, some clinicians continue to use antibiotics in an attempt to prevent CRI. We investigated the effect of extended routine perioperative antibiotic prophylaxis in cardiothoracic patients on rates of intravascular catheter (IVC) colonization and infection. Investigations were undertaken in patients undergoing uncomplicated cardiothoracic surgery during July 2001–February 2002. Patients who received three doses of cefuroxime as perioperative prophylaxis were compared with those who received extended cefuroxime prophylaxis until the IVC was removed. Patients were not randomized into groups, but received the different prophylaxis regimens according to the usual practice of the consultant cardiothoracic surgeon. A roll tip method was used to determine IVC colonization. Of 191 patients who fulfilled the inclusion criteria, 12 were excluded because data were incomplete. One hundred and forty-six patients received routine prophylaxis, and 33 prophylaxis until the IVC was removed. Twenty-three out of 146 (16%) IVCs in the ‘routine’ group and four out of 33 (12%) in the ‘extended’ group became colonized; no IVC-related bloodstream infections occurred during the survey. The duration of IVC placement and the types of operation performed in the two groups were not significantly different (P > 0.05). In routine cardiothoracic surgery patients, extending routine perioperative antibiotic prophylaxis until all IVCs have been removed does not influence rates of IVC colonization.
Keywords: intravascular catheters, antibiotic prophylaxis, coronary artery bypass, valve replacement, infections
* Correspondence address. Department of Microbiology, Leeds General Infirmary and University of Leeds, Old Medical School, Leeds LS1 3EX, UK. Tel: +44-113-392-6818; Fax: +44-113-343-5649; E-mail: J.Sandoe{at}leeds.ac.uk