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Early clinical outcomes of two regimens of prophylactic antibiotics in cardiac surgical patients with delayed sternal closure

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World Journal of Critical Care Medicine 2024年第3期13卷 32-41页

作者： mah.oud ismail allam eissa Rasha Kaddoura Danial Hassan Cornelia S Carr Samy Hanoura Yasser Shouman Abdulwahid Almulla Amr Salah Omar Department of Cardiothoracic Surgery Hamad Medical CooperationDoha 3050Qatar Department of Anesthesia and Intensive Care Al-Azhar UniversityCairo 11651Egypt Department of Pharmacy Heart HospitalHamad Medical CorporationDoha 3050Qatar Department of Healthcare Profession Harvard TH Chan School of Public HealthMinistry of Public HealthBostonMA 3050United States Department of Surgery Qatar UniversityDoha 3050Qatar Department of Cardiac Anesthesia Hamad Medical CorporationDoha 3050Qatar Department of Anesthesia Weill Cornell Medical College in QatarDoha 3050Qatar Department of Critical Care Medicine Beni Suef UniversityBeni Suef 62521Egypt Department of Medicine Weill Cornell Medical College in QatarDoha 3050Qatar

BACKGROUND Delayed sternal closure(DSC)can be a lifesaving approach for certain patients who have undergone cardiac *** value of the type of prophylactic antibiotics in DSC is still *** To investigate clinical outcomes of different prophylactic antibiotic regimens in patients who had DSC after cardiac *** This was a retrospective observational single-center ***-three consecutive patients who underwent cardiac surgery and had an indication for DSC were *** were subjected to two regimens of antibiotics:Narrow-spectrum and broad-spectrum *** The main outcome measures were length of hospital and intensive care unit(ICU)stay,duration of mechanical ventilation,and *** the 53 patients,12(22.6%)received narrow-spectrum antibiotics,and 41(77.4%)received broad-spectrum *** mean age was 59.0±12.1 years,without significant differences between the *** mean duration of antibiotic use was significantly longer in the broad-spectrum than the narrowspectrum group(11.9±8.7 vs 3.4±2.0 d,P<0.001).The median duration of open chest was 3.0(2.0-5.0)d for all patients,with no difference between groups(P=0.146).The median duration of mechanical ventilation was significantly longer in the broad-spectrum group[60.0(Δinterquartile range(IQR)170.0)h vs 50.0(ΔIQR 113.0)h,P=0.047].Similarly,the median length of stay for both ICU and hospital were significantly longer in the broadspectrum group[7.5(ΔIQR 10.0)d vs 5.0(ΔIQR 5.0)d,P=0.008]and[27.0(ΔIQR 30.0)d vs 19.0(ΔIQR 21.0)d,P=0.031].Five(9.8%)patients were readmitted to the ICU and 18(34.6%)patients died without a difference between *** Prophylactic broad-spectrum antibiotics did not improve clinical outcomes in patients with DSC post-cardiac surgery but was associated with longer ventilation duration,length of ICU and hospital stays vs narrow-spectrum antibiotics.

关键词： Cardiac surgery Delayed sternal closure Intensive care Open chest Prophylactic antibiotics

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