Impact of Different Prophylactic Antibiotic Regimen on Clinical Outcome of Coronary Artery Bypass Graft Surgery

Prevention of surgical site infection is the first concern in cardiac surgery. Deep sternal infection causes death in patients and increases the length of hospitalization and the cost of treatment. Several therapeutic protocols have long been used by cardiac surgeons for antimicrobial prophylaxis. The aim of this study is to evaluate the clinical outcomes of prescribing different antibiotic prophylaxis in patients undergoing coronary artery bypass graft surgery.
In this prospective cross-sectional study, 200 patients with a mean age of 60 ± 9.5 years (145 male, 55 female) undergoing elective isolated coronary artery bypass graft (CABG) were enrolled. Post-operative infections, renal and pulmonary complications, the incidence of mortality, length of stay in ICU and hospital were compared and evaluated based on the type of prophylactic antibiotics.
Among the studied subjects, 145 patients (72.5%) were males and 55 patients (27.5%) were female. There was no significant relationship between the administration of antibiotic prophylaxis and renal complications, pulmonary complications, wound infections, mortality, and the mean hospitalization time (P = 0.04). Only the association between clindamycin antibody and mortality rate was statistically significant (P = 0.049). The average duration of admission to the ICU in patients receiving cefazolin antibiotics was significantly lower than those who did not receive this antibiotic (P value = 0.04).
We can conclude that the use of different prophylactic antibiotics in isolated CABG patients, according to the physician's personal preference or experience, does not essentially result in better clinical outcomes and less wound complications and infections. Approved protocol for prophylactic antibiotics was only addressed in half of CABG patients.