The role of long-term antibiotics in the prevention of infection in postoperative cardiac surgeries.
OBJECTIVE
To compare the effect of long-term (7 days) versus short-term (2 days) postoperative antibiotics in preventing postoperative infective complications in patients who have undergone open-heart surgeries.


METHODS
Interventional, randomized controlled trial (RCT).


METHODS
Department of Cardiac Surgery, Dow University of Health Sciences, from February 2006 to July 2006.


METHODS
Cardiac patients (n=42), operated for valvular disease (36%), coronary artery bypass grafting (50%), or septal repair (14%), were included in our study. Patients were prospectively randomized into two groups. Group A (n=21) patients received oral antibiotics for 7 days, whereas group B (n=21) patients were given the same for 2 days postoperative. Pre-operative and intra-operative variables were equal in both groups. Total leukocyte count and temperature were monitored daily until the patients were discharged. The chest and leg wounds were inspected daily for any signs of infection. Sputum and urine cultures were sent for selected patients in case of respiratory tract infection or urinary tract infection, respectively. Each patient was followed until the next routine visit in outpatient department.


RESULTS
In group A, 3 patients (14%), developed infection postoperatively, whereas in group B, 13 patients (62%) (p =0.001) had to be started on oral or intravenous antibiotics as a result of developing either wound infection, a positive sputum culture, a positive urine culture or a localized infection elsewhere. Mean ward stay in group A was 4.8 +/- 4.5 days and in group B 6.5 +/- 4.1 days (p =0.011).


CONCLUSIONS
In this series, there was a significantly higher frequency of infection and longer hospital stay in patients who received antibiotics for 2 days postoperatively as compared to those who received antibiotics for 7 days.
Shahid
Umara
U
Department of Cardiac Surgery, Dow University of Health Sciences, Karachi.
Arain
Mubashir Aslam
MA
Dar
Mudassir Iqbal
MI
Khan
Abdul Bari
AB
Aftab
Sadqa
S
Manan
Atta-Ul-
AU