Journal Article

Glycopeptides Are No More Effective than β-Lactam Agents for Prevention of Surgical Site Infection after Cardiac Surgery: A Meta-analysis

Maureen K. Bolon, Monica Morlote, Stephen G. Weber, Bruce Koplan, Yehuda Carmeli and Sharon B. Wright

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 38, issue 10, pages 1357-1363
Published in print May 2004 | ISSN: 1058-4838
Published online May 2004 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/383318
Glycopeptides Are No More Effective than β-Lactam Agents for Prevention of Surgical Site Infection after Cardiac Surgery: A Meta-analysis

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A meta-analysis was performed to investigate whether a switch from β-lactams to glycopeptides for cardiac surgery prophylaxis should be advised. Results of 7 randomized trials (5761 procedures) that compared surgical site infections (SSIs) in subjects receiving glycopeptide prophylaxis with SSIs in those who received β-lactam prophylaxis were pooled. Neither agent proved to be superior for prevention of the primary outcome, occurrence of SSI at 30 days (risk ratio [RR], 1.14; 95% confidence interval [CI], 0.91–1.42). In subanalyses, β-lactams were superior to glycopeptides for prevention of chest SSIs (RR, 1.47; 95% CI, 1.11–1.95) and approached superiority for prevention of deep-chest SSIs (RR, 1.33; 95% CI, 0.91–1.94) and SSIs caused by gram-positive bacteria (RR, 1.36; 95% CI, 0.98–1.91). Glycopeptides approached superiority to β-lactams for prevention of leg SSIs (RR, 0.77; 95% CI, 0.58–1.01) and were superior for prevention of SSIs caused by methicillin-resistant gram-positive bacteria (RR, 0.54; 95% CI, 0.33–0.90). Standard prophylaxis for cardiac surgery should continue to be β-lactams in most circumstances.

Journal Article.  4511 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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