- CODEN : IAJPBB
- issn 2349-7750
TITLE:
A PROSPECTIVE RANDOMIZED COMPARATIVE STUDY TO DETERMINE THE ROLE OF ANTIBIOTIC PROPHYLAXIS FOR AVERTING SURGICAL SITE INFECTION AFTER CORONARY ARTERY BYPASS GRAFT
AUTHORS:
Dr Saira Fiaz, Dr Farsa Kanwal, Dr Asma Nawaz
ABSTRACT:
Objectives: To compare the outcomes of short-term (24-hour) antibiotic prophylaxis in patients undergoing coronary bypass surgery (CABG) and its effect on deep sternum wound infection (DSWI) / mediastinitis. Place and Duration: Study was conducted at Rawalpindi Institute of Cardiology for one-year duration from May 2019 to May 2020. Patients and Methods: A cross-sectional comparative study was conducted to compare the effect of short (24-hour) ABP on surgical site infections (SSI) and acquired antimicrobial resistance. The study included prospective surveillance of 200 patients undergoing isolated CABG surgery (with / without a pump) meeting the inclusion and exclusion criteria. One hundred patients receiving prophylactic antibiotics for less than 24 hours were compared with another 100 patients receiving prophylactic antibiotics for more than 24 hours. Surgical site infection (SSI) was assessed daily during the patient's stay at the Rawalpindi Institute of Cardiology. Diagnosis of the identified SSI was based on positive cultures, marked dehiscence of the sternum wound, fever, pain, redness, discharge, purulent drainage, and sternum instability. The main exposure was ABP duration and the primary endpoint was DSWI (mediastinitis). Results: During the study period, 9 patients developed DSWI / mediastinitis, the infection rate was 4% in the <24 h ABP group and 5% in the> 24 h ABP group, and the difference was not statistically significant (P = 0.774). The proportion of patients with deep organ space involvement (mediastinitis) and sepsis requiring cable replacement was 3 patients (3%) after 24-hour ABP (P = 0.700). There were no differences between the groups in terms of mortality or the duration of hospitalization (preoperative hospitalization, stay in the intensive care unit, and hospitalization after surgical intervention). The isolated microorganisms showed a similar distribution in both groups. The proportion test was used and it was found that there was no difference in the percentage of infections in the two groups (p-value 0.05). Conclusion: The results confirm that the prophylactic combination of antibiotics with vancomycin and 24-hour aminoglycoside is as effective as prophylaxis given for more than 24 hours in preventing surgical site infection in patients undergoing isolated CABG. Key words: Antibiotic Prophylaxis, Coronary Artery Bypass Graft, Surgical Site Infections
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