Comparison of prophylactic antibiotic regimens in patients undergoing vascular surgery.

An unacceptably high infection rate in patients undergoing vascular surgery prompted two studies on these patients. The first study confirmed the problem and described antibiotic usage which was not standardized. A second double blind randomized study compared antibiotic usage in two groups of patients, receiving vein grafts or synthetic grafts. Patients receiving vein grafts were randomized either to placebo or cefazolin 2 g 1 h pre-operatively and every 6 h for 48 h. Patients receiving synthetic grafts were randomized either to cefazolin 1 g or to cefazolin 2 g 1 h pre-operatively and every 6 h for 48 h. Four of 50 vein graft patients developed a purulent discharge. Two of these infected patients received placebo and two received the cefazolin 2 g protocol. Of 90 patients receiving a synthetic graft, four became infected. Three patients were randomized to the cefazolin 1 g protocol and one to the cefazolin 2 g protocol. No statistically significant differences were observed.