ArticleThe Journal of thoracic and cardiovascular surgery2016
Antibiotic prophylaxis and risk of Clostridium difficile infection after coronary artery bypass graft surgery.
Article in The Journal of thoracic and cardiovascular surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
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Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.
- Diagnostic efficacy of serum presepsin for postoperative infectious complications: a meta-analysis.Frontiers in immunology · 2023Pooled it
- Effectiveness of Single vs Multiple Doses of Prophylactic Intravenous Antibiotics in Implant-Based Breast Reconstruction: A Randomized Clinical Trial.JAMA network open · 2022Trial
- CCL3 and LPS combination therapy significantly reduces infection and stimulates wound healing in diabetic mice by boosting proinflammatory responses.The Journal of investigative dermatology · 2026Article
- Cefazolin Dose-Response-based Correlation of Weight With Orthopaedic Implant-related Surgical-site Infections.Annals of clinical epidemiology · 2026Article
- Trends and Impact ofGastroenterology research · 2026Article
- New Kids on the Block: Estimating Use of Next-generation Gram-negative Antibiotics Across Greater Than 700 Hospitals in the United States.Open forum infectious diseases · 2025Article
- Impact of Perioperative Prophylaxis WithTransplantation direct · 2023Article
- Patterns, Predictors, and Intercenter Variability in Empiric Gram-Negative Antibiotic Use Across 928 United States Hospitals.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Article
- Appropriateness of choice and duration of surgical antibiotic prophylaxis and the incidence of surgical site infections: A prospective study.Journal of Taibah University Medical Sciences · 2023Article
- Review
- Postdischarge prophylactic antibiotics following mastectomy with and without breast reconstruction.Infection control and hospital epidemiology · 2022Article
- Lack of association of post-discharge prophylactic antibiotics with decreased risk of surgical site infection following spinal fusion.The Journal of antimicrobial chemotherapy · 2022Article
- Postdischarge antibiotic use for prophylaxis following spinal fusion.Infection control and hospital epidemiology · 2020Article
- Hospital Infection Control:Clinics in colon and rectal surgery · 2020Review
- Appropriateness of Surgical Antimicrobial Prophylaxis Practices in Australia.JAMA network open · 2019Article
- Real-world effectiveness of infection prevention interventions for reducing procedure-related cardiac device infections: Insights from the veterans affairs clinical assessment reporting and tracking program.Infection control and hospital epidemiology · 2019Article
- Association of Duration and Type of Surgical Prophylaxis With Antimicrobial-Associated Adverse Events.JAMA surgery · 2019Article
- IsJournal of thoracic disease · 2018Article
- A multi-institutional cohort study confirming the risks of Clostridium difficile infection associated with prolonged antibiotic prophylaxis.The Journal of thoracic and cardiovascular surgery · 2018Article
- Prevalence and Predictors of Postdischarge Antibiotic Use Following Mastectomy.Infection control and hospital epidemiology · 2017Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveAntibiotic use, particularly type and duration, is a crucial modifiable risk factor for Clostridium difficile. Cardiac surgery is of particular interest because prophylactic antibiotics are recommended for 48 hours or less (vs ≤24 hours for noncardiac surgery), with increasing vancomycin use. We aimed to study associations between antibiotic prophylaxis (duration/vancomycin use) and C difficile among patients undergoing coronary artery bypass grafting.
methodsWe extracted data on coronary artery bypass grafting procedures from the national Premier Perspective claims database (2006-2013, n = 154,200, 233 hospitals). Multilevel multivariable logistic regressions measured associations between (1) duration (<2 days, "standard" vs ≥2 days, "extended") and (2) type of antibiotic used ("cephalosporin," "cephalosporin + vancomycin," "vancomycin") and C difficile as outcome.
resultsOverall C difficile prevalence was 0.21% (n = 329). Most patients (59.7%) received a cephalosporin only; in 33.1% vancomycin was added, whereas 7.2% received vancomycin only. Extended prophylaxis was used in 20.9%. In adjusted analyses, extended prophylaxis (vs standard) was associated with significantly increased C difficile risk (odds ratio, 1.43; confidence interval, 1.07-1.92), whereas no significant associations existed for vancomycin use as adjuvant or primary prophylactic compared with the use of cephalosporins (odds ratio, 1.21; confidence interval, 0.92-1.60, and odds ratio, 1.39; confidence interval, 0.94-2.05, respectively). Substantial inter-hospital variation exists in the percentage of extended antibiotic prophylaxis (interquartile range, 2.5-35.7), use of adjuvant vancomycin (interquartile range, 4.2-61.1), and vancomycin alone (interquartile range, 2.3-10.4).
conclusionsAlthough extended use of antibiotic prophylaxis was associated with increased C difficile risk after coronary artery bypass grafting, vancomycin use was not. The observed hospital variation in antibiotic prophylaxis practices suggests great potential for efforts aimed at standardizing practices that subsequently could reduce C difficile risk.
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