The effect of first- and third-generation prophylactic antibiotics on hospitalization and medical expenditures for cardiac surgery

Journal of Cardiothoracic Surgery

Euy-Suk Chung¹  Sung-Jin Bae²  Inah Kim³  Jaechul Song³ 

[1] Department of Cardiovascular Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea;Department of Health Science, Hanyang University Graduate School, Seoul, Korea;Department of Cardiovascular Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea;Department of Health Science, Hanyang University Graduate School, Seoul, Korea;Department of Occupational and Environment Medicine, Hanyang University College of Medicine, Seoul, Korea;

关键词: Prophylactic antibiotics;    Surgical site infection;    Propensity score matching;    Medical expenditures;   

DOI  :  10.1186/s13019-022-01763-4

来源: Springer

【 摘 要 】

BackgroundThis study investigated the efficacy of first-generation (cefazolin) and third-generation (ceftizoxime) prophylactic antibiotics in patients undergoing cardiac surgery and the incidence of surgical site infections, hospitalizations, and medical costs.MethodsAll adult patients (≥ 20 years) undergoing cardiac surgery at one hospital from January 01, 2009, to December 31, 2016, were included in this study. A single prophylactic antibiotic was administered at a dose of 1 g within one hour of the surgical incision and for three days after surgery at eight-hour intervals. After propensity score matching, 194 patients in each antibiotic prophylaxis group (first-generation vs third-generation) were analyzed. Among the 388 patients, the incidence of surgical site infections was compared according to the type of prophylactic antibiotic, and risk factors were evaluated by chi-squared tests followed by multivariate logistic regression analysis.ResultsThe incidence of deep surgical site infections was significantly lower in the first-generation group (5.7%) than in the third-generation group (16.5%). The pathogens isolated from the surgical infection sites were similarly distributed in both groups. However, the prevalence of highly infectious gram-positive bacteria was more than that of gram-negative bacteria (67% vs 23%). The preoperative hospitalization duration, mean operation time, and ventilator use time were similar in both groups, but the postoperative hospitalization duration was significantly shorter in the first-generation group (25.5 days) than in the third-generation group (29.8 days). In addition, the medical costs were lower in the first-generation group (20,594 USD) than in the third-generation group (26,488 USD).ConclusionIn conclusion, the first-generation prophylactic antibiotic was better than the third-generation in reducing surgical site infection rates, hospitalization length, and medical expenditures.

【 授权许可】

CC BY