A national survey of antimicrobial prophylaxis in adult cardiac surgery across Canada.
OBJECTIVE
To characterize national and regional patterns of antimicrobial prophylaxis in adult cardiac surgery across Canada.


METHODS
Retrospective, cross-sectional analysis.


METHODS
Thirty-three adult cardiac surgical centres across Canada.


METHODS
A one-page questionnaire collecting information regarding institutional demographics and antimicrobial prophylaxis regimens for adult cardiac surgical procedures was mailed to all adult surgical centres across Canada. If a response was not received within one month, a second survey was mailed, followed by a telephone reminder within two weeks of the second mailing.


RESULTS
The Overall response rate was 100%. Prophylactic antimicrobials were used in all the adult cardiac centres; single-agent prophylaxis was used in 97% (32 of 33) of centres; Single-dose antimicrobial prophylaxis was used in only 3% (one of 33) of centres. Preoperative and postoperative antimicrobial prophylaxis regimens varied both between provinces and within provinces across Canada. Cefazolin was the antimicrobial used in 88% (38 of 43) and 87% (33 of 38) of the reported pre-operative and post-operative prophylaxis regimens, respectively. Antimicrobial prophylaxis was initiated in the operating room 72% (26 of 36) of the time and intra-operative supplemental antimicrobial doses were administered for cardiac procedures longer than a median of 4 hours (range 4 to 8 hr). Overall, the median duration of antimicrobial prophylaxis was 36 hours (range 8 to 96 hr).


CONCLUSIONS
Despite the availability of various published guidelines, our survey identified several areas for improvement with respect to antimicrobial prophylaxis in adult cardiac surgery across Canada.
Paradiso-Hardy
Fran L
FL
Department of Pharmacy, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario;
Cornish
Patti
P
Pharand
Chantal
C
Fremes
Stephen E
SE