Perioperative Prophylaxis with a Beta-Lactam and Vancomycin: Benefits and Risks

Use of a beta-lactam and vancomycin versus either drug alone reduced surgical site infections in cardiac surgery only and was associated more often with acute kidney injury.

The increasing prevalence of resistant Gram-positive pathogens, notably methicillin-resistant Staphylococcus aureus (MRSA), has prompted many surgeons to prescribe vancomycin together with a beta-lactam for perioperative prophylaxis of surgical site infections (SSIs). Whether using two agents is more efficacious than a single agent and what side effects are associated with dual-agent use have not been studied so far.

To examine this issue, researchers retrospectively investigated frequency of SSIs within 30 days after 70,101 surgical procedures (cardiac, orthopedic, vascular, colorectal, or hysterectomy procedures) performed in 109 Veterans Affairs medical centers between October 2008 and September 2012.

A beta-lactam only, vancomycin only, o…

Reviewing Author

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Thomas Glück, MD

Disclosures

Editorial BoardsConsilium Infectiorum by InfectoPharm, Infection

Perioperative Prophylaxis with a Beta-Lactam and Vancomycin: Benefits and Risks

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Reviewing Author