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Ann Thorac Surg 1987;44:508-513
© 1987 The Society of Thoracic Surgeons

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Articles

Infection Prophylaxis in Pulmonary Surgery: A Randomized Prospective Study

From the Department of Surgery, Oulu University Central Hospital, Oulu, Finland

Accepted for publication April 22, 1987.

^* Address reprint requests to Dr. Tarkka, Department of Surgery, Oulu University Central Hospital, SF-90220 Oulu, Finland

A prospective randomized study to evaluate the efficacy of antibiotic prophylaxis against postoperative infections was carried out on 120 patients undergoing pulmonary operations. The patients were randomized into two groups of 60 patients each. One group received doxycycline (deoxytetracycline) prophylaxis for five days, and the other received cefuroxime (a second-generation cephalosporin) for one day. The groups were comparable with regard to age, sex, common risk factors, diagnosis, and operative procedures.

A reduction in the infection rate was noted in the cefuroxime group (10/60) compared with the doxycycline group (19/60), but the difference was not statistically significant (p = 0.055). In major infections (empyema and pneumonia) there was no difference between the groups (4/60 in the cefuroxime group and 5/60 in the doxycycline group), but a significant (p < 0.05) reduction was noted in minor infections (6/56 and 14/55, respectively) such as lower respiratory tract infections and prolonged fever. There were no wound infections in the two study groups. There were significantly (p < 0.05) fewer postoperative fever reactions (axillary temperature > 37.5°C) in the cefuroxime group (30/60) compared with the doxycycline group (44/60).

Both antibiotics were effective in preventing wound infections, but cefuroxime may also be beneficial in preventing minor respiratory infections. The bactericidal effect of cefuroxime may explain this finding.

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