title: Perioperative antimicrobials in chest surgery patients positive for methicillin-resistant Staphylococcus aureus.
abstract: In pulmonary surgery, methicillin-resistant Staphylococcus aureus (MRSA)-positive patients present an issue of perioperative antimicrobials. During 1996 to 2009 in a total of 1,080 pulmonary operations, MRSA was detected before 20 operations. Perioperatively, we followed the Sanford Guide using vancomycin (VCM) or arbekacin (ABK) in MRSA-positive cases at high risk (n = 14), including 1 with clinical infection and 13 with colonization. We used 1-day cefazolin (CEZ) in MRSApositive cases at low risk (n = 6). We defined the outcome as surgical site infection (SSI) that included death from infection. The 14 high-risk cases received a median of 3 days of VCM or ABK, of which 1 (7%) developed SSI. Of the cases given CEZ, we noted SSI in 1 of 6 low-risk cases (17%). Thus, MRSA-positive pulmonary surgery patients at large may receive 3-day VCM or ABK.
authors.affiliation: Department of Chest Surgery, Shimonoseki City Central Hospital, 1-13-1 Koyo-cho, Shimonoseki, Yamaguchi, 750-8520, Japan. yoshidaj@uicalumni.org
authors.forename: Junichi
authors.initials: J
authors.lastname: Yoshida
authors.forename: Koichi
authors.initials: K
authors.lastname: Furugaki
authors.forename: Mayumi
authors.initials: M
authors.lastname: Oyama
mesh_terms: D000890:Anti-Infective Agents / Q000008:administration & dosage*; D003982:Dibekacin / Q000008:administration & dosage / Q000031:analogs & derivatives*; D004334:Drug Administration Schedule; D019983:Guideline Adherence; D006801:Humans; D007564:Japan; D055624:Methicillin-Resistant Staphylococcus aureus / Q000302:isolation & purification*; D019990:Perioperative Care; D017410:Practice Guidelines as Topic; D013510:Pulmonary Surgical Procedures / Q000009:adverse effects; D013203:Staphylococcal Infections / Q000188:drug therapy* / Q000382:microbiology; D013530:Surgical Wound Infection / Q000382:microbiology / Q000517:prevention & control*; D013997:Time Factors; D016896:Treatment Outcome; D014640:Vancomycin / Q000008:administration & dosage*
chemical_list: D000890:Anti-Infective Agents; D003982:Dibekacin; D014640:Vancomycin; C031986:arbekacin