Vascular surgical antibiotic prophylaxis study (VSAPS).
This prospective, randomized study was performed at a single institution. Low-risk patients undergoing elective vascular procedures were enrolled (August 2007 to June 2009). Participants were randomized into 3 separate arms. They received cefazolin, cefazolin + vancomycin, or cefazolin + daptomycin prior to surgery. In total, 169 patients were included in the analysis. Mean age was 64 (range, 26-85), and the patients' comorbidities were similar across all groups. Only Szilagyi II and III infections were analyzed. Any infection/methicillin-resistant Staphylococcus aureus (MRSA) infections was seen in 8 (12.9%)/2 (3.23%) in the cefazolin group, 7 (12.5%)/4 (7.14%) in the cefazolin + vancomycin group, and 2 (3.92%)/(0%) in the cefazolin + daptomycin group. In this study, population of low-risk patients undergoing elective vascular procedures, there was a trend toward fewer infectious complications in the cefazolin + daptomycin group. Adding anti-MRSA agents to the current standard prophylaxis regimen does not appear to reduce the incidence of MRSA infection in low-risk patients.
Patrick
Stone
S
Charleston Division, Vascular Surgery, West Virginia University, WV, USA. pstone0627@yahoo.com
James
Campbell
C
Ali
Aburahma
A
Lawson
Safley
S
Mary
Emmett
E
Modak
Asmita
A
D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D002437:Cefazolin / Q000008:administration & dosage; D016009:Chi-Square Distribution; D017576:Daptomycin / Q000008:administration & dosage; D004334:Drug Administration Schedule; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus / Q000187:drug effects* / Q000302:isolation & purification; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013203:Staphylococcal Infections / Q000382:microbiology / Q000517:prevention & control*; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage; D014656:Vascular Surgical Procedures / Q000009:adverse effects; D014903:West Virginia
D000900:Anti-Bacterial Agents; D014640:Vancomycin; D002437:Cefazolin; D017576:Daptomycin