Background
Antibiotic prophylaxis in cardiac surgery can improve the outcome of cardiothoracic procedures. Therefore, selection of the correct antimicrobial agent, the duration of administration, the time point of administration, and the correct dose have an influence on the success of cardiac surgery. This article gives an overview of daily practices and options pertaining to antibiotic prophylaxis in cardiac surgery.
Materials and methods
A selective literature review was carried out in PubMed.
Results
First- and second-generation cephalosporins are the most frequently administered antibiotics for prophylaxis in cardiac surgery. Most of the pathogens causing surgical site infections are addressed by this group. Vancomycin is a good choice for MRSA-positive patients, or in clinics with a high MRSA prevalence. Duration should not exceed 24 hours. The best time point for administration is during the last hour prior to the first incision. A higher dose than is standard for the particular antibiotic is not beneficial.
Conclusion
Most data exist for first- and second-generation cephalosporins, which are well suited for this indication. To date, there are no German guidelines for antibiotic prophylaxis in cardiac surgery.