Intraoperative redosing of cefazolin did not reduce the overall risk of surgical site infection in cardiac surgery lasting >240 minutes (OR 1.01), but significantly reduced the risk in procedures lasting >400 minutes (adjusted OR 0.44).
Cohort (n=1,548)
No
Does intraoperative redosing of cefazolin reduce the risk of surgical site infection in patients undergoing cardiac surgery?
Intraoperative redosing of cefazolin significantly reduces the risk of surgical site infections in cardiac surgeries lasting longer than 400 minutes.
Odds Ratio: 1.01 (95% CI 0.7–1.47)
Absolute Event Rate: 9.4% vs 9.3%
Intraoperative redosing of prophylactic antibiotics is recommended for prolonged surgical procedures, although its efficacy has not been assessed. We retrospectively compared the risk of surgical site infections in 1,548 patients who underwent cardiac surgery lasting >240 min after preoperative administration of cefazolin prophylaxis. The overall risk of surgical site infection was similar among patients with (43 9.4% of 459) and without (101 9.3% of 1,089) intraoperative redosing (odds ratio OR 1.01, 95% confidence interval CI 0.70-1.47). However, redosing was beneficial in procedures lasting >400 min: infection occurred in 14 (7.7%) of 182 patients with redosing and in 32 (16.0%) of 200 patients without (adjusted OR 0.44, 95% CI 0.23-0.86). Intraoperative redosing of cefazolin was associated with a 16% reduction in the overall risk for surgical site infection after cardiac surgery, including procedures lasting <240 min.
Zanetti et al. (Mon,) conducted a cohort in Cardiac surgery (n=1,548). Intraoperative redosing of cefazolin vs. No intraoperative redosing was evaluated on Surgical site infection (OR 1.01, 95% CI 0.70-1.47). Intraoperative redosing of cefazolin did not reduce the overall risk of surgical site infection in cardiac surgery lasting >240 minutes (OR 1.01), but significantly reduced the risk in procedures lasting >400 minutes (adjusted OR 0.44).