Comparative Analysis of Antibiotic Prophylaxis Guidelines in Cardiac Surgery: A Survey in Czechia and Slovakia

J Hosp Infect. 2024 Dec 13:S0195-6701(24)00403-1. doi: 10.1016/j.jhin.2024.11.019. Online ahead of print.

Abstract

Objectives: Surgical site infections (SSIs) in cardiac surgery significantly impact patient outcomes. This study examines cardiac antimicrobial prophylaxis guidelines in Czech and Slovak hospitals, crucial for reducing SSI incidence.

Methods: An electronic survey was conducted across cardiac surgery departments in both countries, focusing on surgical antibiotic prophylaxis (SAP) protocols, antibiotic choices, dosages, timing, and postoperative infection rates. Responses were collected over three months, ensuring a comprehensive overview.

Results: Most surveyed hospitals (79 %) implement SAP, but guidelines exhibit notable variability. Cefazolin dominates as the primary prophylactic choice, with varying dosing regimens. Challenges include timing inconsistencies and prolonged prophylaxis durations, particularly in implant-related procedures. Regular guideline revisions are reported in 18 % of hospitals within the last year, emphasizing the need for updated practices.

Conclusion: This study shows the importance of standardizing SAP practices, aligning them with evolving evidence, and implementing regular guideline revisions. The observed variations highlight opportunities for enhanced SSI prevention strategies in cardiac surgery, ultimately contributing to improved patient outcomes.

Keywords: Czech Republic; Slovakia; antibiotic prophylaxis; cardiac surgery; surgical site infection.