title: Cefamandole versus cefonicid prophylaxis in cardiovascular surgery: a prospective study.
abstract: We randomized 400 patients who were scheduled for an elective cardiovascular operation involving median sternotomy to receive cefamandole nafate or cefonicid in a prospective double-blind study. Three hundred fifty-seven patients were evaluable for prophylactic efficacy. Chest wound and donor site infections and early prosthetic valve endocarditis occurred more frequently with cefonicid (11 patients, 6.3%) than with cefamandole (4 patients, 2.2%) (p = 0.05). Three patients, all in the cefonicid group, required sternal debridement to control postoperative deep wound infections. Twenty-five miscellaneous postoperative infections (urinary tract infection, pneumonia, intravenous site infection, bacteremia, sepsis, Clostridium difficile diarrhea) occurred in 16 patients (9.19%) in the cefonicid group and four in 4 patients (2.19%) in the cefamandole group (p = 0.003). These data indicate that cefamandole is superior to cefonicid in preventing both surgical wound infections and miscellaneous nonsurgical infections after cardiovascular operations.
authors.affiliation: Department of Medicine, Methodist Hospital, Memphis, Tennessee.
authors.forename: M S
authors.initials: MS
authors.lastname: Gelfand
authors.forename: B P
authors.initials: BP
authors.lastname: Simmons
authors.forename: P
authors.initials: P
authors.lastname: Schoettle
authors.forename: O B
authors.initials: OB
authors.lastname: Harrington
authors.forename: F
authors.initials: F
authors.lastname: Martin
authors.forename: E W
authors.initials: EW
authors.lastname: Owen
authors.forename: R B
authors.initials: RB
authors.lastname: Craft
authors.forename: N
authors.initials: N
authors.lastname: Amarshi
mesh_terms: D006348:Cardiac Surgical Procedures; D002435:Cefamandole / Q000627:therapeutic use*; D015790:Cefonicid / Q000627:therapeutic use*; D004311:Double-Blind Method; D004697:Endocarditis, Bacterial / Q000517:prevention & control; D004756:Enterobacteriaceae Infections; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D006801:Humans; D011292:Premedication; D011446:Prospective Studies; D011897:Random Allocation; D013203:Staphylococcal Infections; D013530:Surgical Wound Infection / Q000517:prevention & control
chemical_list: D002435:Cefamandole; D015790:Cefonicid