Antibiotic prophylaxis for cardiac surgery — are we getting it right?

Keryn J Christiansen
Med J Aust 2010; 192 (3): . || doi: 10.5694/j.1326-5377.2010.tb03446.x
Published online: 1 February 2010

The latest evidence for the essential elements of surgical prophylaxis protocols

There is no question that antibiotic prophylaxis for cardiac surgery reduces surgical site infections.1 The successful implementation of prophylactic regimens, however, is often inconsistent or inadequate. The use of prophylaxis protocols or decision-support systems as either a single measure2 or as part of a patient care pathway3 has been demonstrated to improve adherence to prophylaxis, with a reduction in surgical site infections. In this issue of the Journal (page 141), a study by Haydon and colleagues4 shows that antibiotic prophylaxis protocol use in 45 Australian cardiac surgery units increased significantly between 2004 and 2008 (from 58% to 80%), but concordance with version 13 of the Australian Therapeutic guidelines: antibiotic5 was poor when both choice of agent and duration of administration were considered. In particular, there was an increased use of multidrug regimens, an increased use of vancomycin for routine prophylaxis, and a prolonged duration. The study did not examine surgical site infection rates.

  • Keryn J Christiansen1,2

  • 1 PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA.
  • 2 School of Pathology and Laboratory Medicine, University of Western Australia, Perth, WA.

Competing interests:

I am a member of the writing committee for version 14 of Therapeutic guidelines: antibiotic and responsible for the review of the surgical prophylaxis chapter.


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