title: Comparison of vancomycin and cefuroxime for infection prophylaxis in coronary artery bypass surgery.
abstract: OBJECTIVE
  To investigate clinically significant differences between vancomycin and cefuroxime for perioperative infection prophylaxis in coronary artery bypass surgery.
  
  
  METHODS
  A total of 884 patients were randomized prospectively to receive either cefuroxime (444) or vancomycin (440) and were assessed for infectious complications during hospitalization and 1 month postoperatively.
  
  
  METHODS
  A university hospital.
  
  
  RESULTS
  The overall immediate surgical-site infection rate was 3.2% in the cefuroxime group and 3.5% in the vancomycin group (difference, -0.3; 95% confidence interval, -2.6-2.1).
  
  
  CONCLUSIONS
  The data suggest that vancomycin has no clinically significant advantages over cephalosporin in terms of antimicrobial prophylaxis. We suggest that cefuroxime (or first-generation cephalosporins, which were not studied here) is a good choice for infection prophylaxis in connection with coronary artery bypass surgery in institutions without methicillin-resistant Staphylococcus aureus problems. In addition to the increasing vancomycin-resistant enterococci problem, the easier administration and usually lower price of cefuroxime make it preferable to vancomycin.
authors.affiliation: Department of Surgery, University of Oulu, Finland. Sailaritta.Vuorisalo@fimnet.fi
authors.forename: S
authors.initials: S
authors.lastname: Vuorisalo
authors.forename: R
authors.initials: R
authors.lastname: Pokela
authors.forename: H
authors.initials: H
authors.lastname: Syrjälä
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D002444:Cefuroxime / Q000627:therapeutic use*; D002511:Cephalosporins / Q000627:therapeutic use*; D001026:Coronary Artery Bypass; D005260:Female; D005387:Finland; D006801:Humans; D008297:Male; D008875:Middle Aged; D013503:Surgery Department, Hospital; D013530:Surgical Wound Infection / Q000517:prevention & control*; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D014640:Vancomycin; D002444:Cefuroxime