WITH THE reports of bacterial strains becoming resistant to antibiotics14 and indications that prophylactic antibiotics effect no reduction in the incidence of surgical infections generally,12 the concept has evolved that antibiotic therapy should be reserved for the specific treatment of infections. However, three factors are unique in open cardiac surgery in contrast to operations on other organs. First, the threat of bacterial endocarditis is increased in patients with cardiac disease. Second, the use of extracorporeal circulation for cardiopulmonary bypass repeatedly exposes the entire blood volume to contamination from the environment. Third, while wound infections in other surgical procedures cause morbidity, but rarely mortality, a serious infection in the patient having cardiac surgery is likely to terminate fatally.
Therefore, the following retrospective study was made to assess the possible role of antibiotics on the incidence of bacterial endocarditis and other clinical infections complicating open cardiac surgery.
NELSON RM, JENSON CB, PETERSON CA, SANDERS BC. Effective Use of Prophylactic Antibiotics in Open Heart Surgery. Arch Surg. 1965;90(5):731-736. doi:10.1001/archsurg.1965.01320110067012