Prevention of prosthetic vascular graft infection by rifampicin impregnation of a protein-sealed Dacron graft in combination with parenteral cephalosporin.
Antibiotic-impregnated prosthetic vascular grafts have been shown to be highly resistant to bacterial contamination in animal models. The aim of this study was to assess if graft infection in an animal model challenged with local bacterial contamination could be reduced further by the use of rifampicin soaking of a protein-sealed Dacron graft in addition to the prophylaxis provided by perioperative intravenous cephalosporin. Of 20 Merino sheep given cefoxitin intravenously before the induction of anaesthesia, ten had a rifampicin treated Dacron graft implanted into the common carotid artery (group 1), and ten received an untreated Dacron graft (group 2). Before wound closure the grafts were inoculated with 1 ml of 10(8) colony forming units per ml of Staphylococcus aureus. After three weeks the grafts were removed and cultured. Group 1 sheep had fewer graft infections (two of 10) compared to group 2 (six of eight survivors), this difference being statistically significant (p = 0.03; Fisher exact test). It is concluded that rifampicin treatment of protein-sealed Dacron grafts combined with intravenous cefoxitin provides more protection from contaminating Staphylococcus aureus than intravenous cefoxitin alone in this animal model.
Avramovic
J
J
Department of Surgery, Westmead Hospital, NSW, Australia.
Fletcher
J P
JP
D000818:Animals; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D002440:Cefoxitin / Q000627:therapeutic use*; D004359:Drug Therapy, Combination / Q000008:administration & dosage / Q000627:therapeutic use; D005780:Gelatin; D007275:Injections, Intravenous; D011093:Polyethylene Terephthalates; D016459:Prosthesis-Related Infections / Q000517:prevention & control*; D012293:Rifampin / Q000008:administration & dosage / Q000627:therapeutic use*; D012756:Sheep
D011093:Polyethylene Terephthalates; D002440:Cefoxitin; D005780:Gelatin; D012293:Rifampin