On antibiotic prophylaxis in cardiac surgery: A risk factor for wound infection

D. E. Lilienfeld, D. Vlahov, J. H. Tenney, J. S. McLaughlin

Research output: Contribution to journalArticle


During a 30-month period, median sternotomy wound infections or endocarditis developed during the first 60 days postoperatively following 20 of 1,204 (1.7%) adult cardiac procedures at the University of Maryland Hospital. Fifty percent of the infected patients received perioperative clindamycin prophylaxis. A retrospective study was conducted in which the odds ratio estimate of the relative risk of sternotomy infection or endocarditis for patients receiving clindamycin prophylaxis compared with patients receiving cefamandole was found to be 17.0 (p <.001) using population controls and 8.25 (p <.001) using matched controls. Seventy-five percent of the organisms causing infections, principally Staphylococcus epidermidis, were resistant in vitro to clindamycin. Perioperative clindamycin administration was not fully effective in preventing wound infection following cardiac surgery at our hospital, thus providing indirect evidence for the efficacy of prophylaxis with cephalosporin-containing regimens. Trials of alternative antibiotics to clindamycin for prophylaxis in penicillin-allergic patients undergoing cardiac surgery are indicated.

Original languageEnglish (US)
Pages (from-to)670-674
Number of pages5
JournalAnnals of Thoracic Surgery
Issue number6
Publication statusPublished - 1986
Externally publishedYes


ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Lilienfeld, D. E., Vlahov, D., Tenney, J. H., & McLaughlin, J. S. (1986). On antibiotic prophylaxis in cardiac surgery: A risk factor for wound infection. Annals of Thoracic Surgery, 42(6), 670-674.