Vol. 19 No. 4 (2015)
ACQUIRED HEART DISEASES

Effect of topical vancomycin on organ functions after heart surgery

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  • N. Shikhverdiev,
  • G. Khubulava,
  • S. Marchenko,
  • V. Suvorov
N. Shikhverdiev
Saint-Petersburg Pediatric Medical University, 2 Litovskaiya St., 194100 Saint-Petersburg, Russian Federation; Sergey Kirov Military-Medical Academy, Ministry of Defense of Russian Federation, 6 Academician Lebedev St., 194044 Saint-Petersburg, Russian Federation
G. Khubulava
Saint-Petersburg Pediatric Medical University, 2 Litovskaiya St., 194100 Saint-Petersburg, Russian Federation; Sergey Kirov Military-Medical Academy, Ministry of Defense of Russian Federation, 6 Academician Lebedev St., 194044 Saint-Petersburg, Russian Federation
S. Marchenko
Saint-Petersburg Pediatric Medical University, 2 Litovskaiya St., 194100 Saint-Petersburg, Russian Federation
V. Suvorov
Saint-Petersburg Pediatric Medical University, 2 Litovskaiya St., 194100 Saint-Petersburg, Russian Federation
DOI: https://doi.org/10.21688/1681-3472-2015-4-34-37

Published 2016-01-11

Keywords

  • local antibiotics,
  • topical administration of vancomycin,
  • sternal infection,
  • mediastinitis prophylaxis,
  • prevention of sternal infection

How to Cite

Shikhverdiev, N., Khubulava, G., Marchenko, S., & Suvorov, V. (2016). Effect of topical vancomycin on organ functions after heart surgery. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 19(4), 34–37. https://doi.org/10.21688/1681-3472-2015-4-34-37

Copyright (c) 2016 Shikhverdiev N.N., Khubulava G.G., Marchenko S.P., Suvorov V.V.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Objective. Focus in the study was placed on topical administration of vancomycin on hepatic and renal functions of cardiac patients.
Methods. A retrospective analysis of treatment of 184 patients who underwent cardiac surgery in the period from 2009 to 2013 was done. Antibiotics were applied locally for prevention of sternal wound infection. All patients underwent cardiac surgery via median longitudinal sternotomy. Before closing the chest, antibiotic of the glycopeptide group (vancomycin) was topically applied. The influence of topical vancomycin on the hepatic and renal functions was accessed.
Results. Statistical analysis of data showed that the level of AST before surgery (M = 33.23; SD = 6.8) was above that of AST in the postoperative period (M = 32.18; SD = 7.6) by an average of 1.049 (t = 1.406; p = 0.161. [95% CI. –0.423; 2.521]). ALT level before surgery (M = 34.6; SD = 5.4) was higher comparing to that in the postoperative period (M = 34.5; SD = 4.5) by an average of 0.08 (t = 0.157; p = 0.875 [95% CI. –0.878; 1.03]). The differences were not statistically significant. This leads to the conclusion that there is no effect of topical application of vancomycin on the levels of AST and ALT in the postoperative period.
The creatinine values in the postoperative period (M = 73.6; SD = 16.4) were higher than those before surgery (M = 71.3; SD = 17.05) by an average of 2.3 (t = –1.308; p = 0.192. [95% CI. –5.807; 1.177]). The differences were not statistically significant. It means that there is no influence of local topical vancomycin on serum creatinine level.
Conclusion. Topical application of vancomycin in the postoperative period has no impact on the level of AST, ALT and creatinine in blood plasma. Also, when applied locally in cardiac patients, vancomycin does not lead to the dysfunction of kidneys and liver.

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References

  1. Chen L.F., Arduino J.M., Sheng S. Epidemiology and outcome of major postoperative infections following cardiac surgery: risk factors and impact of pathogen type // Am. J. Infect. Control. 2012. Vol. 40. № 10. P. 963–968.
  2. Brandyk D.F. Vascular surgical site infection: risk factors and preventive measures // Semin. Vasc. Surg. 2008. Vol. 3. P. 119–123.
  3. Yarboro S.R., Baum E.J., Dahners L.E. Locally administered antibiotics for prophylaxis against surgical wound infection. An in vivo study // J. Bon. Joint. Surg. Am. 2007. Vol. 89. № 5. 929–933.
  4. Cavanaugh D.L., Berry J., Yarboro S.R., Dahners L.E. Better prophylaxis against surgical site infection with local as well as systemic antibiotics. An in vivo study // J. Bone Joint Surg. Am. 2009. Vol. 91. № 8. P. 1907–1912.
  5. Vander Salm T.J., Okike O.N., Pasque M.K., Pezzella A.T., Lew R., Traina V., Mathieu R. Reduction of sternal infection by application of topical vancomycin // J. Thorac. Cardiovasc. Surg. 1989. Vol. 98. № 4. P. 618–622.
  6. Зайчик А.Ш., Чурилов Л.П. Патофизиология. Общая патофизиология с основами иммунопатологии / Учебник. 4-е изд. СПб: ЭЛБИ-СПб, 2008. Т. 1. С. 443–444.
  7. Junker J.P., Lee C.C., Samaan S., Hackl F., Kiwanuka E., Minasian R.A., Tsai D.M., Tracy L.E., Onderdonk A.B., Eriksson E., Caterson E.J. Topical delivery of ultrahigh concentrations of gentamicin is highly effective in reducing bacterial levels in infected porcine full-thickness wounds // Plast. Reconstr. Surg. 2015. Vol. 135. № 1. P. 151–159.
  8. Хубулава Г.Г., Шихвердиев Н.Н., Наумов А.Б., Суворов В.В., Марченко С.П., Аверкин И.И. Патофизиологические механизмы и факторы риска развития стернальной инфекции в кардиохирургии // Вестник Росcийской военно-медицинской академии. 2013. Т. 41. № 1. С. 174–179.
  9. Schilling A., Neuner E., Rehm S.J. Vancomycin: a 50-something-year-old antibiotic we still don’t understand // Cleve Clin. J. Med. 2011. Vol. 78. № 7. P. 465–471.
  10. Halasz N.A. Wound infection and topical antibiotics: the surgeon’s dilemma // Arch. Surg. 1977. Vol. 112. P. 1240–1244.
  11. Desmond J., Lovering A., Harle C., Djorevic T., Millner R. Topical vancomycin applied on closure of the sternotomy wound does not prevent high levels of systemic vancomycin // Eur. J. Cardiothorac. Surg. 2003. Vol. 23. № 5. P. 765–770.