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Antibiotic prophylaxis in cardiothoracic surgery 1990: results of a third survey.

The use of prophylactic antibiotics for cardiothoracic surgery has become an accepted medical practice. The choice of drug and duration of therapy is controversial, however. In 1985 and 1988 the authors conducted telephone surveys of cardiothoracic surgery programs to determine the most frequently used agents. The survey was repeated in in 1990. In the 1990 telephone survey, all 51 hospitals contacted in 1988 responded. Of the hospitals responding, 31 (61%) had standard regimens used for all patients and 19 (37%) used automatic stop orders for these regimens. In institutions with standard regimens, 18 (58%) used first-generation cephalosporins, 8 (26%) cefuroxime and 4 (13%) cefamandole. First-generation cephalosporins were included in 33 (48%) of the 69 regimens reported to be used in all hospitals surveyed. Cefuroxime, cefamandole, ceftriaxone, and vancomycin were all used in multiple hospitals. Eight (16%) hospitals changed regimen in the last 12 months, with three of these changing to cefuroxime. The data obtained in this most recent survey are similar to the data obtained in the 1985 and 1988 reports. The results of this survey indicated that most hospitals continue to use first-generation cephalosporins for antibiotic prophylaxis in cardiothoracic surgery, but there is considerable variation among institutions.