Nooyen S M, Overbeek B P, Brutel de la Rivière A, Storm A J, Langemeyer J J
Department of Anaesthesiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1994 Dec;13(12):1033-7. doi: 10.1007/BF02111823.
To assess the efficacy of single-dose antibiotic prophylaxis in coronary artery bypass grafting, 1,016 consecutive patients were prospectively randomized to receive either a single dose or a three-day course of cefuroxime. Nine patients (0.9%) died within seven days; no death was caused by infection. For various reasons 163 other patients were not evaluable. Therefore, 844 patients were evaluated. Patients in group A (n = 419) received 20 mg/kg cefuroxime intravenously at induction of anaesthesia; group B (n = 425) received the same dose followed by 750 mg t.i.d. for three consecutive days. Both groups were comparable regarding all risk factors. The efficacy of the prophylactic regimens was evaluated by comparison of occurrence of wound infection in both groups. No significant differences in wound infection were observed between the two treatment groups: sternal site infection in the single-dose prophylaxis group was 14% versus 13% in the three-day course group; donor site infection occurred in 38% versus 39%. It is concluded that in coronary artery bypass grafting a single dose of cefuroxime is as effective as a three-day course in the prevention of wound infection.
为评估单剂量抗生素预防在冠状动脉搭桥术中的疗效，1016例连续患者被前瞻性随机分组，分别接受单剂量或为期三天疗程的头孢呋辛。9例患者（0.9%）在七天内死亡；无一例死亡由感染所致。由于各种原因，另有163例患者无法进行评估。因此，对844例患者进行了评估。A组（n = 419）患者在麻醉诱导时静脉注射20mg/kg头孢呋辛；B组（n = 425）患者先接受相同剂量，随后连续三天每日三次每次750mg。两组在所有风险因素方面具有可比性。通过比较两组伤口感染的发生率来评估预防方案的疗效。两个治疗组之间在伤口感染方面未观察到显著差异：单剂量预防组的胸骨部位感染率为14%，三天疗程组为13%；供体部位感染率分别为38%和39%。得出的结论是，在冠状动脉搭桥术中，单剂量头孢呋辛在预防伤口感染方面与三天疗程同样有效。
