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Background and purpose: Surgical site infection (SSI) is the third leading cause of hospital infections which results in increased morbidity, mortality and costs after cardiac surgery. The importance of prophylactic antibiotics in cardiac surgery has been proved. The aim of this randomized clinical trial was to compare two prophylactic antibiotic regimens (cefazolin and cefazolin plus gentamicin) on surgical site infection in CABG patients in Mazandaran Heart Center. Materials and methods: A total of 400 patients, meeting eligibility criteria, were randomly allocated into two groups. In the control group the prophylactic regimen consisted of cefazolin 2 g IV prior to sternal incision followed by 1 g IV every 6 hours for 72 hours. The intervention group recieved cefazolin 2 g IV plus gentamicin 1.5mg/kg IV before sternal incision followed by cefazolin 1 g IV every 6 hours plus gentamicin 1.5mg/kg IV every 8 hours for 72hrs after the sternal incision. Three, seven, 21 and 30 days after cardiac surgery the patients were observed by a cardiac surgeon for symptoms of surgical wound infection. Moreover, the serum level of creatinine and BUN were measured before the surgery and also in second and forth days after the surgery. Results: From the total of 400 patients 392 were assessed of whom 198 were in control group and 194 were in the intervention group. There was no significant difference between the two groups regarding demographic and clinical variables and also the rate of infection (P>0.05). However, the serum level of creatinine and BUN were significantly higher in intervention group (P<0.05). Conclusion: Since there was no significant difference in infection rates between the two groups and significant increase in serum level of creatinine and BUN in intervention group, using cefazolin as the sole prophylactic antibiotic is suggested to prevent surgical site infection in CABG patients. (Clinical Trials Registry Number: IRCT201201114365N10)

Keywords: Surgical site infection, antibiotic, cefazolin, gentamicin, prophylaxis, cardiac surgery

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