PERIOPERATIVE ANTIBIOTIC PROPHYLAXIS IN CARDIAC SURGERY. WHAT SHOULD WE KNOW

Introduction Perioperative antibiotic prophylaxis has proved to reduce the number of postoperative infections. In cardiac surgery, the infections in the surgical site are found to be around 0.4-4%. The most common bacterias causing surgical site infections in cardiac surgery are gram-positive. Our aim in to guide the reader in the decision of choosing the most adequate Perioperative Antibiotic Prophylaxis in each patient according to their characteristics and their environment. Methods The most recent bibliography was reviewed searching the most common antibiotics used in perioperative Antibiotic Prophylaxis in cardiac surgery. A bibliographic search was carried out in the PubMed-MEDLINE database. A peer review was performed and a total of 4 references of more than 30 were selected. Results There is no difference in the Surgical Site Infections between the use of 1st generation of Cephalosporin or Glycopeptides such as Vancomycin or Teicoplanin. On the other hand, 1st generation of Cephalosporin reduces the incidence of infections produced by Staphylococcus. Nevertheless, Glycopeptides are better at avoiding infection produced by Staphylococcus and Enterococcus resistant than Cephalosporin. Discussion Choosing Perioperative Antibiotic Prophylaxis must be individualized according to the bacterial flora in the environment, the different characteristics of the patients, and the type of cardiac surgery. Also, a high incidence of Staphylococcus Aureus methicillin-resistant must receive prophylaxis with Vancomycin and a second antibiotic should be considered.