+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Antibiotic prophylaxis in heart surgery

, : Antibiotic prophylaxis in heart surgery. Annales Francaises D'anesthesie et de Reanimation 13(5 Suppl): S78-S87

Cardiac surgery enters mainly into the class I of Altemeier ("clean surgery"). However, many factors may explain an intraoperative contamination: surgery of long duration, extra-corporeal circulation, aspiration of blood and air, immunodepression...). In fact, the infectious risk decreases from about 25% with placebo to 5% with prophylactic antibiotics. The staphylococcal infections are the most frequent (mediastinitis, endocarditis, parietal infections...). Cephalosporins, particularly of second-generation type (cefamandole, cefuroxime), perform better than antistaphylococcal penicillins. The combination with an amino-side may be used when Gram negative bacilli infection prevalence is high. Vancomycin is efficient but hypotension and renal impairment have been reported. Therefore, vancomycin is used in patients allergic to cephalosporins, when a high prevalence of methicillin-resistant Staphylococcus or enterococci infections is reported, or when the patient has recently received broad-spectrum antimicrobial therapy. The antibiotic doses must take into account the haemodilution due to extracorporeal circulation and the necessity to obtain sufficient serum concentrations throughout surgery. A prophylaxis of more than 48 hours is not associated with an improved outcome. In cardiac transplantation a prophylaxis is essential, but is still questioned during the insertion of pace-markers. In any case, the antibiotic prophylaxis must take into account the bacterial prevalence of each institution.


PMID: 7778817

Other references

Grunberger, G.; Chen, L.; Rodriguez, A.; Tinahones, F.J.; Jacober, S.J.; Bue-Valleskey, J., 2016: A randomized clinical trial of basal insulin peglispro vs NPH in insulin-naïve patients with type 2 diabetes: the IMAGINE 6 trial. Basal insulin peglispro (BIL) has a longer duration of action than conventional insulin analogues and a hepato-preferential mechanism of action. This study assessed whether BIL was non-inferior to isophane insulin (NPH) in reducing HbA1c in insuli...

Schiff, R.; Rosenbluth, J., 1986: Ultrastructural localization of laminin in rat sensory ganglia. We adapted immunocytochemical methods for localization of laminin to examine its disposition in neural tissue at the ultrastructural level. In dorsal root ganglia, laminin was found in basal laminae of the satellite and Schwann cells ensheathing n...

Stacey, D.L.; Gibala, M.J.; Martin Ginis, K.A.; Timmons, B.W., 2010: Effects of recovery method after exercise on performance, immune changes, and psychological outcomes. Randomized controlled trial using a repeated-measures design. To examine the effects of commonly used recovery interventions on time trial performance, immune changes, and psychological outcomes. The use of cryotherapy is popular among athletes, b...

Traynor, K., 2012: Pertzye approved for pancreatic insufficiency. American Journal of Health-System Pharmacy 69(13): 1094-1094

Carlson, E.A.; Muller, H.J., 1967: H.J. Muller. December 21, 1890--April 5, 1967. Genetics 56(3): Suppl:s23-6; Goetze Hans Juergen, 1999: Comparison of some gridding methods. The Leading Edge (Tulsa, OK): , Pages 898-900. 1999.

Baudiere, A.S.rve, L., 1976: Vegetation groups of the Pla de Gorra Blanc (Puigmal massif, Pyrenees Orientales). attempt of its phytosociological and phytogeographical interpretation. Naturalia monspeliensia Serie botanique: ub 1976), 25 5-21

Koga, N.; Iwata, Y., 1991: Pathological and angiographic regression of coronary atherosclerosis by LDL-apheresis in a patient with familial hypercholesterolemia. We present the case of a 42-year-old male with familial hypercholesterolemia (FH) who had received long-term low-density lipoprotein (LDL)-apheresis before death occurred, presumably from an arrhythmia. He had been treated with double filtration p...

Guo, B.; Naish, S.; Hu, W.; Tong, S., 2015: The potential impact of climate change and ultraviolet radiation on vaccine-preventable infectious diseases and immunization service delivery system. Climate change and solar ultraviolet radiation may affect vaccine-preventable infectious diseases (VPID), the human immune response process and the immunization service delivery system. We systematically reviewed the scientific literature and iden...

Hu, B.; Cushman, J.; Deng, F., 1997: Nonlocal reactive transport with physical, chemical, and biological heterogeneity. When a natural porous medium is viewed from an eulerian perspective, incomplete characterization of the hydraulic conductivity, chemical reactivity, and biological activity leads to nonlocal constitutive theories, irrespective of whether the mediu...