Cefamandole versus cefonicid prophylaxis in cardiovascular surgery: a prospective study.
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.
Gelfand
M S
MS
Department of Medicine, Methodist Hospital, Memphis, Tennessee.
Simmons
B P
BP
Schoettle
P
P
Harrington
O B
OB
Martin
F
F
Owen
E W
EW
Craft
R B
RB
Amarshi
N
N
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
D002435:Cefamandole; D015790:Cefonicid