Alterations of coagulase-negative staphylococcal flora in cardiac surgery patients: comparative study between cefamandole and pefloxacin perioperative prophylaxis.
The changes in coagulase-negative staphylococcal flora induced by cefamandole prophylaxis were compared with those induced by pefloxacin prophylaxis among patients undergoing heart valve surgery. Twenty-five patients (15 receiving cefamandole prophylaxis and 10 receiving pefloxacin prophylaxis) were included in the study. In the pefloxacin group, colonization rates in anterior nares and in chest skin or wound that were 60% and 50% respectively before surgery, became 50% and 20% respectively after surgery. In the cefamandole group, colonization rates in anterior nares and chest skin or wound were 53.3% and 60% respectively before surgery and became 53.3% and 40% respectively after surgery. Cefamandole did not appear to induce the emergence of oxacillin or pefloxacin resistant coagulase-negative staphylococcal colonization in any cultured site. On the other hand pefloxacin appeared somewhat more efficacious than cefamandole in eradicating staphylococcal flora of anterior nares and chest skin or wound. Pefloxacin and oxacillin resistant strains were found in the perianal area in 0% of patients before pefloxacin prophylaxis and in 70% of patients after pefloxacin prophylaxis. However, further studies are necessary to confirm the emergence of antibiotic resistant coagulase-negative staphylococci in the intestinal microflora after quinolone administration. The clinical implications of such apparently disturbing phenomenon remain to be evaluated.
Baiocchi
P
P
Patologia Medica III, Università degli Studi La Sapienza, Roma.
Venditti
M
M
Santini
C
C
Santoro
R
R
Tarasi
A
A
Gelfusa
V
V
Brandimarte
C
C
Serra
P
P
D002435:Cefamandole / Q000627:therapeutic use*; D003030:Coagulase / Q000378:metabolism; D006350:Heart Valve Prosthesis; D006801:Humans; D009666:Nose / Q000382:microbiology; D015366:Pefloxacin / Q000627:therapeutic use*; D011182:Postoperative Care; D011292:Premedication; D016032:Randomized Controlled Trials as Topic; D012867:Skin / Q000382:microbiology; D013203:Staphylococcal Infections / Q000517:prevention & control*; D013210:Staphylococcus / Q000187:drug effects / Q000201:enzymology
D003030:Coagulase; D015366:Pefloxacin; D002435:Cefamandole