Calculated Empiric Antibiotic Therapy of Nosocomial Infection in Cardiac Surgery Patients

Abstract

Objectives: There is a wide variation of hospital-acquired infections in the postoperative period ranging from 2.7% to 26.8%. In case of clinically suspected hospital-acquired infection the diagnosis is sometimes difficult, since clinical and laboratory signs of inflammation may be caused not only by infection, but also by tissue injury and mainly by the systemic inflammatory response syndrome associated with cardiopulmonary bypass. The choice of empirical therapy depends on the suspected site of infection and local microbial-susceptibility patterns. Inappropriate or delayed antibiotic treatment is associated with increased mortality. Thus, intravenous antibiotic therapy should be started as early as possible and should cover all likely pathogens. Structured deescalation concepts and strict limitation of treatment duration should lead to reduced selection pressure.