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Canadian Journal of Infectious Diseases
Volume 13, Issue 1, Pages 21-27
http://dx.doi.org/10.1155/2002/370389
Special Article

A National Survey of Antimicrobial Prophylaxis in Adult Cardiac Surgery Across Canada

Fran L Paradiso-Hardy,1,2 Patti Cornish,1 Chantal Pharand,3 and Stephen E Fremes4

1Department of Pharmacy, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada
2Divisions of Cardiology and Clinical Pharmacology, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada
3Department of Pharmacy, Hôpital Sacré-Coeur, Montreal, Quebec, Canada
4Division of Cardiovascular Surgery, Sunnybrook and Women’s College Health Sciences Centre, Toronto, Ontario, Canada

Received 30 January 2001; Revised 19 April 2001

Copyright © 2002 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

OBJECTIVE: To characterize national and regional patterns of antimicrobial prophylaxis in adult cardiac surgery across Canada.

DESIGN: Retrospective, cross-sectional analysis.

SETTING: Thirty-three adult cardiac surgical centres across Canada.

INTERVENTIONS: A one-page questionnaire collecting information regarding institutional demographics and antimicrobial prophylaxis regimens for adult cardiac surgical procedures was mailed to all adult surgical centres across Canada. If a response was not received within one month, a second survey was mailed, followed by a telephone reminder within two weeks of the second mailing.

MAIN RESULTS: The overall response rate was 100%. Prophylactic antimicrobials were used in all of the adult cardiac centres; single-agent prophylaxis was used in 97% (32 of 33) of centres. Single-dose antimicrobial prophylaxis was used in only 3% (one of 33) of centres. Preoperative and postoperative antimicrobial prophylaxis regimens varied both between provinces and within provinces across Canada. Cefazolin was the antimicrobial used in 88% (38 of 43) and 87% (33 of 38) of the reported preoperative and postoperative prophylaxis regimens, respectively. Antimicrobial prophylaxis was initiated in the operating room 72% (26 of 36) of the time, and intraoperative supplemental antimicrobial doses were administered for cardiac procedures that took longer than a median of 4 h (range 4 to 8 h). Overall, the median duration of antimicrobial prophylaxis treatment was 36 h (range 8 to 96 h).

CONCLUSIONS: Despite the availability of various published guidelines, the present survey identified several areas for improvement with respect to antimicrobial prophylaxis in adult cardiac surgery across Canada.