[HSF] Re: Post op antibiotics

[A]

Dave:
I add my voice to Hal's very interesting concept CRP level as a marker for a
potential mediastinitis. In your case what antibiotic do you start the
patient on and for how long if the CRP level is rising? Reference please.
Thank you for this info

Ahmed

-----Original Message-----
From: openheart-l-bounces at lists.hsforum.com
[mailto:openheart-l-bounces at lists.hsforum.com] On Behalf Of David Harris
Sent: Saturday, September 22, 2007 2:16 PM
To: OpenHeart-L at lists.hsforum.com
Subject: RE: [HSF] Re: Post op antibiotics

For CABG patients 24 hrs.

For valves, until lines and drains out.

Then track the CRP levels every second day to make
sure the trend is downward, and there is no peak just
before discharge. This way you can avoid
mediastinitis, as you can treat it as it starts.
Since doing this have not had a single case of sternal
sepsis in the last 700 patients, but have had CRP
peaks which we then confirm the next day, then treat.
Some developed cellulitis a few days afterwards, while
on treatment, but we were able to avoid debridements.

Dave Harris


--- Adam Saltman <aes.md.phd at hotmail.com> wrote:

> It is actually policy at our institution now to
> discontinue all prophylactic antibiotics according
> to a time schedule. For general surgery patients
> this is after 24 hours, and for cardiac patients it
> is 48 hours (which actually has no data behind it,
> just some hysterical cardiac surgeons). This is now
> becoming a nation-wide initiative in the prevention
> of infection by drug-resistant organisms... But as
> far as I know, there is no data to support or refute
> any particular strategy in cardiac patients...
> 
> Adam
> 
> 
> 
> > From: alsadd at ksu.edu.sa
> > To: OpenHeart-L at lists.hsforum.com
> > Date: Wed, 19 Sep 2007 14:58:29 -0700
> > CC: 
> > Subject: [HSF] Re: Post op antibiotics 
> > 
> > Dear Forum Members:
> > 
> >  
> > 
> > Do the honorable members keep the open heart
> patients on antibiotics for as
> > long as they have mediastinal and chest tubes in
> place? I do not, but some
> > of my colleagues do. I went over the STS
> guidelines the two parts and I
> > could not find the answer to this question.
> > 
> > Your response is greatly appreciated.
> > 
> > Thank you
> > 
> >  
> > 
> > Ahmed
> > 
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Dr. David G. Harris, FCS, MMED,
Cardiothoracic Surgeon        
Suite 207                                
Kuils River Private Hospital,        
PO Box 1200, Kuils River, 7579, Cape Town, South Africa.            
Tel +27-21-9006411             
Fax +27-21-9006412      Mobile +27-83-3309587

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