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Paper Information

Journal:   MEDICAL JOURNAL OF TABRIZ UNIVERSITY OF MEDICAL SCIENCES   Fall 2003 , Volume - , Number 59; Page(s) 36 To 40.
 
Paper: 

STUDY ON PROPHYLACTIC USAGE OF ANTIBIOTICS IN PATIENTS UNDERGOING CORONARY ARTERY BYPASS GRAFTS

 
 
Author(s):  HASANZADEH SALMASI S.*, PARVIZI R.
 
* Research Center, Shahid Madani Heart Hospital, Tabriz University of Medical Sciences
 
Abstract: 

Background and Objectives: Infections acquired in the heart surgery, especially in coronary artery bypass grafts (CABGs), present as mediastinitis and sternal dehiscence. Their prevalence is about 0.8-1.5%. According to several studies, administration of prophylactic antibiotics is essential in CABG procedures. In these procedures, while inducing anesthesia, before establishing cardiopulmonary bypass, and after disconnecting it, intravenous antibiotics are given and maintained for 48 hours after operation, before extubation and disconnecting IV lines; then, antibiotics are discontinued. The aim of this research was to evaluate the present antibiotic therapies, to get information on the type and dosage of the prescribed antibiotics in patients undergoing CABG, and to introduce a new method for antibiotic prescribing.

Materials and Methods: This research was a quasi experimental study on 100 male patients with coronary artery diseases who had undergone CABGs in Shahid Madani Heart Hospital, Tabriz. For collecting data in both groups, a questionnaire is used, consisting following features: gender, age, weight, risk factors, duration of operation, anesthesia and CPB, ejection fraction (EF), the number of grafts, expected time for surgery, the time of chest tube connection, the presence of infectious, urinary and pulmonary diseases, and also history of endocarditis, clinical laboratory tests (including ESR1, ESR2, WBC count, and blood, urine and wound cultures), body temperature 24, 48, 72 hours after the operation, and finally the doses of prescribed oral orparenteral antibiotics. The statistical analysis was performed with SPSS software and was done through descriptive statistical method.

Results: The study was performed on 100 patients, divided into two groups, with mean age of 53.30±9.60 years old in the first and 54.66± 8.87 years old in the second group. The mean weight of patients was 74.40 ±12.45 kg in first group and 74.16 ± 10.50 kg in second group. According to results, not a single case was reported to develop urinary and respiratory tract infection or endocarditis. After surgery, based on clinical laboratory tests, all patients were in normal range. Blood, urine and wound cultures also were negative and 72 hours after surgery, no patient was reported to develop fever. Patients were followed for one month, for signs of infection. In this study, total dosage of antibiotics was decreased 15g, 10.47 ± 1.09 g of which was for oraldrugs.
Conclusion: Findings suggest that oral antibiotic therapy plays no important role in management of postoperative infections. With the use of standard prophylactic antibioics, antibiotic overuse can be prevented. In this research, the dosage of antibiotics was decreased from 34 g to 199, which may be helpful also in decreasing complications and cost of treatment.

 

 

 

 
Keyword(s): CABG, ANTIBIOTIC, PROPHYLACTIC
 
References: 
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