title: Cardiac surgery antibiotic prophylaxis and calculated empiric antibiotic therapy.
abstract: BACKGROUND
  Ongoing debate exists concerning the optimal choice and duration of antibiotic prophylaxis as well as the reasonable calculated empiric antibiotic therapy for hospital-acquired infections in critically ill cardiac surgery patients.
  
  
  METHODS
  A nationwide questionnaire was distributed to all German heart surgery centers concerning antibiotic prophylaxis and the calculated empiric antibiotic therapy.
  
  
  RESULTS
  The response to the questionnaire was 87.3%. All clinics that responded use antibiotic prophylaxis, 79% perform it not longer than 24 h (single-shot: 23%; 2 doses: 29%; 3 doses: 27%; 4 doses: 13%; and >5 doses: 8%). Cephalosporin was used in 89% of clinics (46% second-generation, 43% first-generation cephalosporin). If sepsis is suspected, the following diagnostics are performed routinely: wound inspection 100%; white blood cell count 100%; radiography 99%; C-reactive protein 97%; microbiological testing of urine 91%, blood 81%, and bronchial secretion 81%; procalcitonin 74%; and echocardiography 75%. The calculated empiric antibiotic therapy (depending on the suspected focus) consists of a multidrug combination with broad-spectrum agents.
  
  
  CONCLUSIONS
  This survey shows that existing national guidelines and recommendations concerning perioperative antibiotic prophylaxis and calculated empiric antibiotic therapy are well applied in almost all German heart centers.
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Armin
authors: A
authors: Gorski
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Khaled
authors: K
authors: Hamouda
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Mehmet
authors: M
authors: Özkur
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Markus
authors: M
authors: Leistner
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Sebastian-Patrick
authors: SP
authors: Sommer
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany.
authors: Rainer
authors: R
authors: Leyh
authors: Department of Cardiothoracic and Thoracic Vascular Surgery, University Hospital Würzburg, Würzburg, Germany Schimmer_c@klinik.uni-wuerzburg.de.
authors: Christoph
authors: C
authors: Schimmer
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data; D001424:Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects* / Q000401:mortality; D004334:Drug Administration Schedule; D006801:Humans; D013530:Surgical Wound Infection / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotic prophylaxis; Bacterial infections; Cardiac surgical procedures; Catheters; Drug administration schedule; Indwelling; Surgical wound infection