- 期刊
Vancomycin用於預防冠狀動脈繞道手術感染的角色：一個前瞻性研究
The Use of Vancomycin for the Surgical Prophylaxis in Coronary Artery Bypass Surgery: A Prospective Study
摘要
From 50 to 82.2% of the nosocomial isolates of Staph yloccus aureus and Staphylococcus epidermidis in major hospitals in Taiwan are oxacillin-resistant, and were 73% and 91% at our hospital. Glycopeptides are now being used frequently for the surgical prophylaxis. To assess the role of the vancomycin in the prophylaxis in coronary artery bypass surgery (CABG), we conducted a prospective study comparing two regimens of antibiotics: one with cefuroxime+gentamicin, and the other, cefuroxime+gentamicin+vancomycin. From January to July, 2000, 32 patients received the first regimen and 37 patients received the second. The two groups of patients were comparable in all potential risk factors. The result indicates that there were no statistical differences in the median hospital stay (11 days vs. 13 days; p=0,134), and episodes of post-operative infections (1 vs. 4; p=0.235). There was a significant difference in the cost of antibiotics between the two groups (NT 4,629 vs. NT 7,020; p=0,001). Our data suggest that the addition of vancomycin provides no extra benefit over cefuroxime + gentamicin in the surgical prophylaxis for the CABG. We suggest that vancomycin is not needed for the surgical prophylaxis in CABG.
並列摘要
From 50 to 82.2% of the nosocomial isolates of Staph yloccus aureus and Staphylococcus epidermidis in major hospitals in Taiwan are oxacillin-resistant, and were 73% and 91% at our hospital. Glycopeptides are now being used frequently for the surgical prophylaxis. To assess the role of the vancomycin in the prophylaxis in coronary artery bypass surgery (CABG), we conducted a prospective study comparing two regimens of antibiotics: one with cefuroxime+gentamicin, and the other, cefuroxime+gentamicin+vancomycin. From January to July, 2000, 32 patients received the first regimen and 37 patients received the second. The two groups of patients were comparable in all potential risk factors. The result indicates that there were no statistical differences in the median hospital stay (11 days vs. 13 days; p=0,134), and episodes of post-operative infections (1 vs. 4; p=0.235). There was a significant difference in the cost of antibiotics between the two groups (NT 4,629 vs. NT 7,020; p=0,001). Our data suggest that the addition of vancomycin provides no extra benefit over cefuroxime + gentamicin in the surgical prophylaxis for the CABG. We suggest that vancomycin is not needed for the surgical prophylaxis in CABG.
延伸閱讀
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