Jornal Vascular Brasileiro
https://jvascbras.org/article/doi/10.1590/S1677-54492007000400012
Jornal Vascular Brasileiro
Original Article

Profilaxia antimicrobiana em cirurgia vascular periférica: cefalosporina ainda é o padrão-ouro?

Antimicrobial prophylaxis in peripheral vascular surgery: is cephalosporin still the gold standard?

Eduardo Lichtenfels; Márcio L. Lucas; Ronaldo Webster; Pedro A. d' Azevedo

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Resumo

Nas cirurgias vasculares periféricas, as cefalosporinas têm seu uso consagrado como agente antimicrobiano profilático de escolha. Recentemente, observamos uma mudança nos padrões de colonização, prevalência de patógenos e suscetibilidade geral aos antimicrobianos. Os patógenos multirresistentes vêm se tornando cada vez mais freqüentes nas infecções de ferida cirúrgica vascular, demonstrando variações regionais e locais quanto à suscetibilidade aos antimicrobianos profiláticos utilizados na rotina cirúrgica. Os dados e a literatura disponível até o momento demonstram que não existe evidência suficiente para uma mudança na rotina profilática perioperatória. Entretanto, devemos levar em consideração os padrões regionais e institucionais de prevalência de patógenos resistentes e padrões de suscetibilidade aos antimicrobianos para estabelecer guias e orientações específicas para a utilização de antimicrobianos profiláticos alternativos.

Palavras-chave

Antibioticoprofilaxia, infecção da ferida operatória, procedimentos cirúrgicos vasculares, cirurgia

Abstract

In peripheral vascular surgery, cephalosporins are nowadays regarded as the first choice for operative antibiotic prophylaxis. We have recently observed changes in colonizing patterns, pathogen prevalence and antibiotic susceptibility to antimicrobials. Multiresistant pathogens are becoming more frequent in vascular surgical wound infections, showing regional and local variations as to prophylactic antibiotic susceptibility. Data from the available literature so far have shown no strong evidence for a change in routine surgical antibiotic prophylaxis. We must consider regional and institutional prevalence of pathogen resistance and patterns of antibiotic susceptibility to establish specific guidelines for the use of alternative antibiotics.

Keywords

Antibiotic prophylaxis, surgical wound infection, vascular surgical procedures, surgery

References

Dellinger EP. Infecções cirúrgicas e escolha dos antimicrobianos. Sabiston: tratado de cirurgia. 2003:182-200.

Fry DE. Surgical infections. 1995.

Howard RJ, Simmons RL. Surgical infectious diseases. 1994.

de Lalla F. Surgical prophylaxis in practice. J Hosp Infect. 2002;50(^sA):S9-12.

Akalin HE. Surgical prophylaxis: the evolution of guidelines in an era of cost containment. J Hosp Infect. 2002;50(^sA):S3-7.

Burke JF. Identification of the source of staphylococci contaminating the surgical wound during operation. Ann Surg. 1963;158:898-904.

Dellinger EP, Ehrenkranz NJ. Surgical infections. Hospital infections. 1998:571-85.

Cruse PJ, Foord R. The epidemiology of wound infection: A prospective study of 62,939 wounds. Surg Clin North Am. 1980;60:27-40.

Linton RR. The prophylactic use of the antibiotics in clean surgery. Surg Gynecol Obstet. 1961;112:218-20.

Greif R, Akça O, Horn EP, Kurz A, Sessler DI. Supplemental perioperative oxygen to reduce the incidence of surgical-wound infection: Outcomes Research Group. N Engl J Med. 2000;342:161-7.

Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization: Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334:1209-15.

Page CP, Bohnen JM, Fletcher JR, McManus AT, Solomkin JS, Wittmann DH. Antimicrobial prophylaxis for surgical wounds: Guidelines for clinical care. Arch Surg. 1993;128:79-88.

Manian FA, Meyer L. Comprehensive surveillance of surgical wound infections in outpatient and inpatient surgery. Infect Control Hosp Epidemiol. 1990;11:515-20.

Olson MM, Lee JT Jr. Continuous, 10-year wound infection surveillance: Results, advantages, and unanswered questions. Arch Surg. 1990;125:794-803.

Bailey IS, Karran SE, Toyn K, Brough P, Ranaboldo C, Karran SJ. Community surveillance of complications after hernia repair surgery. BMJ. 1992;304:469-71.

Platt R, Zaleznik DF, Hopkins CC. Perioperative antibiotic prophylaxis for herniorrhaphy and breast surgery. N Engl J Med. 1990;322:153-60.

Platt R, Zucker JR, Zaleznik DF. Prophylaxis against wound infection following herniorrhaphy or breast surgery. J Infect Dis. 1992;166:556-60.

Lewis RT, Weigand FM, Mamazza J, Lloyd-Smith W, Tataryn D. Should antibiotic prophylaxis be used routinely in clean surgical procedures: a tentative yes. Surgery. 1995;118:742-6.

Leaper D. Use of antibiotic prophylaxis in clean non-implant wounds. J Antimicrob Chemother. 1998;41:501-4.

de Lalla F. Antimicrobial chemotherapy in the control of surgical infectious complications. J Chemother. 1999;11:440-5.

Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR. Guideline for prevention of surgical site infection. Am J Infect Control. 1999;27:97-132.

Kernodle DS, Classen DC, Burke JP, Kaiser AB. Failure of cephalosporins to prevent Staphylococcus aureus surgical wound infections. JAMA. 1990;263:961-9.

Kreter B, Woods M. Antibiotic prophylaxis for cardiothoracic operations: Meta-analysis of thirty years of clinical trials. J Thorac Cardiovasc Surg. 1992;104:590-9.

Pehlivan M, Hayran M, Akalin HE. Antibacterial use at Iiacettepe University Hospital: Differences between specialities on appropriate use. .

Fraise AP. Guidelines for the control of methicillin-resistant Staphylococcus aureus. J Antimicrob Chemother. 1998;42:287-9.

Katzung BG, Ehrlich KS. Drogas utilizadas em infecções bacterianas, fúngicas e virais. Farmacologia clínica. 1991:132-80.

Tice AD. Pharmacoeconomic considerations in the ambulatory use of parenteral cephalosporins. Drugs. 2000;59:29-35.

Barrionuevo CE, Koning MB, Capasso R, Barrionuevo R. Eficácia do uso da cefazolina per-operatória em dose única na profilaxia da infecçäo pós-operatória em cirurgias näo infectadas. Rev Bras Med Otorrinolaringol. 1995;2:432.

Moya M, Antonio D, Collazo Herrera M, Pisonero Socías J, Pardo Gómez G. Evaluación económica del uso de Cefazolina versus Ceftriazona en la profilaxis perioperatoria. Rev cuba Farm. 2001;35:187-191.

Valle Panchana G, Abarca Aguilar F, Rivera Escalante V, Rivera Drouet R. Cefazolina y su uso como profilaction en cirurgia. Rev Univ Guayaquil. 1987;2:59-68.

Baca Tinoco C. Uso de antibiótico para profilaxis quirúrgica en el servicio de cirugía general del HEODRA, en el período enero a diciembre 2003. León. 2004:45.

Saab A, Suckerman-Voldman E, Rodríguez AR. Profilaxia con antibióticos en cirugía: experiencia en el Servicio de Emergencia de un Hospital Universitário. Antibiot Infecc. 1995;5:13-6.

Bencini PL, Signorini M, Galimberti M, Cavicchini S, Caputo R. Preoperative antibiotic prophylaxis in flexural surgery of difficult contamination-prone areas of the skin: the utility of a single dose of antibiotic. J Dermatol Treat. 1994;5:17-9.

Fonseca SN, Kunzle SR, Junqueira MJ, Nascimento RT, de Andrade JI, Levin AS. Implementing 1-dose antibiotic prophylaxis for prevention of surgical site infection. Arch Surg. 2006;141:1109-14.

Iribarren O, Araujo M. Effect of antimicrobial prophylaxis on the incidence of infections in clean surgical wounds in hospitals undergoing renovation: Infection control and hospital epidemiology. Infect Control Hosp Epidemiol. 2006;27:1372-6.

Fatica CA, Gordon SM, Zins JE. The role of preoperative antibiotic prophylaxis in cosmetic surgery. Plast Reconstr Surg. 2002;109:2570-3.

Moreira RC, Timi JR, Abrão E. Estudo prospectivo da antibioticoprofilaxia em operaçöes de fístula artério-venosa para diálise. Rev Angiol Cir Vasc. 1992;1:108-11.

Del Canto Harboe E, Urbina CR. Estudio de portación nasal de staphylococcus aureus en estudiantes de medicina de la Universidad de Santiago de Chile. Clin Cienc. 2001;1:10-14.

Robledo JÁ, López J, Sierra P, Robledo C, Pfaller MA, Jones RN. El programa de vigilancia antimicrobiana SENTRY en Colombia: hallazgos iniciales en tres hospitales de Medellín. Infectio. 1999;3:100-7.

Terzi C, Kilic D, Unek T, Hosgorler F, Fuzun M, Ergor G. Single-dose oral ciprofloxacin compared with single-dose intravenous cefazolin for prophylaxis in inguinal hernia repair: a controlled randomized clinicalstudy. J Hosp Infect. 2005;60:340-7.

Thomas R, Alvino P, Cortino G R. Long-acting versus short-acting cephalosporins for preoperative prophylaxis in breast surgery: a randomized double-blind trial involving 1,766. Chemotherapy. 1999;45:217-23.

Marroni M, Cao P, Fiorio M. Prospective, randomized, double-blind trial comparing teicoplanin and cefazolin as antibiotic prophylaxis in prosthetic vascular surgery. Eur J Clin Microbiol Infect Dis. 1999;18:175-8.

Allababidi S, Shah JC. Efficacy and pharmacokinetics of site-specific cefazolin delivery using biodegradable implants in the prevention of post-operative wound infections. Pharm Res. 1998;15:325-33.

Giacometti A, Cirioni O, Ghiselli R. Mupirocin prophylaxis against methicillin-susceptible, methicillin-resistant, or vancomycin-intermediate Staphylococcus epidermidis vascular-graft infection. Antimicrob Agents Chemother. 2000;44:2842-4.

Yasim A, Gul M, Atahan E, Ciragil P, Aral M, Ergun Y. Efficacy of vancomycin, teicoplanin and fusidic acid as prophylactic agents in prevention of vascular graft infection: an experimental study in rat. Eur J Vasc Endovasc Surg. 2006;31:274-9.

Earnshaw JJ. Methicillin-resistant Staphylococcus aureus: vascular surgeons should fight back. Eur J Vasc Endovasc Surg. 2002;24:283-6.

Murphy GJ, Pararajasingam R, Nasim A, Dennis MJ, Sayers RD. Methicillin-resistant Staphylococcus aureus infection in vascular surgical patients. Ann R Coll Surg Engl. 2001;83:158-63.

McManus AT, Goodwin CW, Pruitt BA Jr. Observations on the risk of resistance with the extended use of vancomycin. Arch Surg. 1998;133:1207-11.

Schwalbe RS, Stapleton JT, Gilligan PH. Emergence of vancomycin resistance in coagulase-negative staphylococci. N Engl J Med. 1987;316:927-31.

Zanetti G, Goldie SJ, Platt R. Clinical consequences and cost of limiting use of vancomycin for perioperative prophylaxis: example of coronary artery bypass surgery. Emerg Infect Dis. 2001;7:820-7.

Merrer J, Desbouchages L, Serazin V, Razafimamonjy J, Pauthier F, Leneveu M. Comparison of routine prophylaxis with vancomycin or cefazolin for femoral neck fracture surgery: microbiological and clinical outcomes. Infect Control Hosp Epidemiol. 2006;27:1366-71.

Martone WJ. Spread of vancomycin-resistant enterococci: why did it happen in the United States?. Infect Control Hosp Epidemiol. 1998;19:539-45.

Hirose K, Marui A, Arai Y. Sustained-release vancomycin sheet may help to prevent prosthetic graft methicillin-resistant Staphylococcus aureus infection. J Vasc Surg. 2006;44:377-82.

de Lalla F. Antibiotic prophylaxis in orthopedic prosthetic surgery. J Chemother. 2001;1:48-53.

Vardakas KZ, Soteriades ES, Chrysanthopoulou1 A, Papagelopoulos PJ, Falagas ME. Perioperative anti-infective prophylaxis with teicoplanin compared to cephalosporins in orthopaedic and vascular surgery involving prosthetic material. Clin Microbiol Infect. 2005;11:775-7.

de Lalla F, Novelli A, Pellizzer G. Regional and systemic prophylaxis with teicoplanin in monolateral and bilateral total knee replacement procedures: study of pharmacokinetics and tissue penetration. Antimicrob Agents Chemother. 1993;37:2693-8.

Nehrer S, Thalhammer F, Schwameis E, Breyer S, Kotz R. Teicoplanin in the prevention of infection in total hip replacement. Arch Orthop Trauma Surg. 1998;118:32-6.

Mini E, Nobili S, Periti P. Does surgical prophylaxis with teicoplanin constitute a therapeutic advance?. J Chemother. 2000;12:40-55.

Chervu A, Moore WS, Gelabert HA, Colburn MD, Chvapil M. Prevention of graft infection by use of prostheses bonded with a rifampin/collagen release system. J Vasc Surg. 1991;14:521-4.

Harvey RA, Alcid DV, Greco RS. Antibiotic bonding to polytetrafluoroethylene with tridodecylmethylammonium chloride. Surgery. 1982;92:504-12.

Osada T, Yamamura K, Fujimoto K. Prophylaxis of local vascular graft infection with levofloxacin incorporated into albumin-sealed Dacron graft. Microbiol Immunol. 1999;43:317-21.

Bandyk D F, Novotney ML, Back MR, Johnson BL, Schmacht DC. Expanded application of in situ replacement for prosthetic graft infection. J Vasc Surg. 2001;34:411-20.

Goeau-Brissonniere O, Leport C, Bacourt F, Lebrault C, Comte R, Pechere JC. Prevention of vascular graft infection by rifampin bonding to a gelatin-sealed Dacron graft. Ann Vasc Surg. 1991;5:408-12.

Vicaretti M, Hawthorne WJ, Ao PY, Fletcher JP. An increased concentration of rifampicin bonded to gelatin-sealed Dacron reduced the incidence of subsequent graft infections following a staphylococcal challenge. Cardiovasc Surg. 1998;6:268-73.

Ghiselli R, Giacometti A, Goffi L. Prophylaxis against Staphylococcus aureus vascular graft infection with mupirocin-soaked, collagen-sealed Dacron. J Surg Res. 2001;99:316-20.

Sutherland R, Boon RJ, Griffin KE, Masters PJ, Slocombe B, White AR. Antibacterial activity of mupirocin (pseudomonic acid), a new antibiotic for topical use. Antimicrob Agents Chemother. 1985;27:495-8.

Cookson BD. The emergence of mupirocin resistance: a challenge to infection control and antibiotic prescribing practice. J Antimicrob Chemother. 1998;41:11-8.

Giacometti A, Cirioni O, Ghiselli R. Efficacy of quinupristin-dalfopristin in preventing vascular graft infection due to Staphylococcus epidermidis with intermediate resistance to glycopeptides. Antimicrob Agents Chemother. 2002;46:2885-8.

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