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, Sharon B. Wright

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

125 Scopus citations

Abstract

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.

Original languageEnglish
Pages (from-to)1357-1363
Number of pages7
JournalClinical Infectious Diseases
Volume38
Issue number10
DOIs
StatePublished - 15 May 2004
Externally publishedYes

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