Antibiotic prophylaxis and risk of Clostridium difficile infection after coronary artery bypass graft surgery

摘要: Abstract Objective Antibiotic use, particularly type and duration, is a crucial modifiable risk factor for Clostridium difficile . Cardiac surgery of particular interest because prophylactic antibiotics are recommended 48 hours or less (vs ≤24 hours noncardiac surgery), with increasing vancomycin use. We aimed to study associations between antibiotic prophylaxis (duration/vancomycin use) C among patients undergoing coronary artery bypass grafting. Methods extracted data on grafting procedures from the national Premier Perspective claims database (2006-2013, n = 154,200, 233 hospitals). Multilevel multivariable logistic regressions measured (1) duration ( as outcome. Results Overall prevalence was 0.21% (n = 329). Most (59.7%) received cephalosporin only; in 33.1% added, whereas 7.2% only. Extended used 20.9%. In adjusted analyses, extended (vs standard) associated significantly increased (odds ratio, 1.43; confidence interval, 1.07-1.92), no significant existed use adjuvant primary compared cephalosporins 1.21; 0.92-1.60, odds 1.39; 0.94-2.05, respectively). Substantial inter-hospital variation exists percentage (interquartile range, 2.5-35.7), 4.2-61.1), alone 2.3-10.4). Conclusions Although after grafting, not. The observed hospital practices suggests great potential efforts at standardizing that subsequently could reduce risk.