Randomized comparison of cefamandole, cefazolin, and cefuroxime prophylaxis in open-heart surgery.
A total of 337 patients undergoing coronary artery bypass grafting or cardiac valve replacement were randomly assigned to receive cefazolin (1 g every 8 h [q8h]), cefamandole (2 g q6h), or cefuroxime (1.5 g q12h) as an intravenous antibiotic prophylaxis. All drugs were administered within 60 min before the initial incision and were continued for 48 h postoperatively. No adverse effects related to the study drugs were observed. The percentage of patients with postoperative infection was 9% for the cefazolin group, 6% for the cefamandole group, and 5% for the cefuroxime group or 6.5% overall. There were more infection sites in patients treated with cefazolin than in those treated with cefuroxime (P = 0.05) or cefamandole (P = 0.06). Fewer wound infections occurred with cefuroxime (P less than 0.01) and cefamandole (P = 0.06) than with cefazolin. Analyses of the prophylactic regimens used in this study showed cefazolin and cefuroxime to be less costly than cefamandole.
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D002435:Cefamandole / Q000627:therapeutic use; D002437:Cefazolin / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003365:Costs and Cost Analysis; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D011292:Premedication; D011897:Random Allocation
D002511:Cephalosporins; D002435:Cefamandole; D002437:Cefazolin; D002444:Cefuroxime