Clinical Consequences and Cost of Limiting Use of Vancomycin for Perioperative Prophylaxis: Example of Coronary Artery Bypass Surgery
2001

Cost-Effectiveness of Vancomycin vs. Cefazolin for Heart Surgery

Sample size: 10000 publication Evidence: high

Author Information

Author(s): Giorgio Zanetti, Sue J. Goldie, Richard Platt

Primary Institution: Brigham and Women's Hospital

Hypothesis

Is vancomycin more effective and cost-efficient than cefazolin for perioperative prophylaxis in coronary artery bypass graft surgery?

Conclusion

Vancomycin is usually more effective and less expensive than cefazolin for perioperative antibiotic prophylaxis in coronary artery bypass graft surgery.

Supporting Evidence

  • Vancomycin resulted in 7% fewer surgical site infections compared to cefazolin.
  • Routine vancomycin use saved $1,170,000 per 10,000 patients compared to routine cefazolin.
  • Cefazolin resulted in fewer infections and deaths than no prophylaxis.

Takeaway

Using vancomycin instead of cefazolin can help prevent more infections and save money during heart surgery.

Methodology

Decision-analytic models were used to compare clinical outcomes and costs of no prophylaxis, cefazolin, and vancomycin in coronary artery bypass graft surgery.

Limitations

The study did not model the relationship between antibiotic prophylaxis and resistance, which may impact the results.

Participant Demographics

Patients undergoing coronary artery bypass graft surgery.

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