Perioperative antibiotic prophylaxis in heart and vascular surgery. A prospective randomized comparative study with cefazolin and ceftriaxone

: Two different forms of cephalosporin prophylaxis were investigated in a prospective randomized comparative study: a one-day cefazoline prophylaxis (Kefzol 0.5 g every six hours) and a single dose of ceftriaxone (Rocephin 2 g). A total of 541 patients were included in the study over 10 months: 272 in the cefazoline (CFZ) group and 269 in the ceftriaxone (CRO) group. The patients were checked postoperatively for an infection. The total rate of infections was 4.7%; 4.6% in the CFZ group and 4.8% in the CRO group. A wound infection occurred in 1.1% of the cases, in 0.4% of the CFZ group and in 1.8% of the CRO group. Septicemia was diagnosed in 1.5% of the operated patients; in 1.2% of the patients treated with CFZ and in 1.8% of the patients treated with CRO. 1.3% of the patients developed pneumonia, 1.8% in the CFZ and 0.8% in the CRO group. Only one patient had a urinary tract infection (CFZ group). Furthermore, two double infections occurred in the CFZ group. A double infection was observed only once in the CRO group. Fever of unclear etiology developed in 3.6% of the patients in both groups. There was no statistically significant difference with regard to the rate of infection between the two groups. A single administration of ceftriaxone prophylaxis is accordingly just as effective as a one-day cefazoline prophylaxis. Despite reduction of the antibiotic application, the rate of infection has not risen in the last five years. The single application is advantageous compared to longer-term applications.