Antibiotic prophylaxis for cardiac surgery in Australia

Haydon, TP, Presneill, JJ and Robertson, MS (2010) Antibiotic prophylaxis for cardiac surgery in Australia. Medical Journal of Australia, 192 3: 141-143.

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Author Haydon, TP
Presneill, JJ
Robertson, MS
Title Antibiotic prophylaxis for cardiac surgery in Australia
Journal name Medical Journal of Australia   Check publisher's open access policy
ISSN 0025-729X
Publication date 2010-02-01
Sub-type Article (original research)
Volume 192
Issue 3
Start page 141
End page 143
Total pages 3
Place of publication Strawberry Hills, Australia
Publisher Australasian Medical Publishing Company
Collection year 2011
Language eng
Formatted abstract
Objective: To evaluate national practice for antibiotic prophylaxis in cardiac surgery with
respect to the use of protocols, agent selection and duration of administration.
Design, setting and participants: Two point-prevalence surveys of intensive care units in
24 public and 27 private hospitals performing cardiac surgery in Australia, conducted in
2004 and 2008, using a structured telephone questionnaire of the attending senior
intensive care clinician in each unit.
Main outcome measures: Existence of a protocol in the unit for antibiotic prophylaxis,
specific antibiotic agents used and their duration of administration.
Results: Between 2004 and 2008, reported protocol use increased from 58% to 80%
(P=0.02), while concordance with version 13 of the Australian Therapeutic guidelines:
for both choice of agent and timing (duration of administration) remained
around 10%. Use of multiple agents was common, as was continued antibiotic
administration after completion of surgery. Over 4 years, the proportion of cardiac surgical
units reporting vancomycin administration for routine valve surgery prophylaxis doubled
to 62% (P<0.001).
Conclusion: Despite an increase in reported protocol use for antibiotic prophylaxis in
cardiac surgery, concordance with national antibiotic guidelines remained low, with
duration of antibiotic administration deviating most from recommendations. Prophylactic
vancomycin use appears to have increased substantially in recent years. Clinical
implementation of recommended perioperative cardiac surgical antibiotic prophylaxis
may not occur until supported by evidence from either a large prospective randomised
study or standardised national surveillance of cardiac surgical site infection rates.
©The Medical Journal of Australia 2010
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Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Medicine Publications
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Created: Sun, 21 Mar 2010, 00:02:41 EST