Evidence map›Paper›PMID 41009912›Full record

ReviewAntibiotics (Basel, Switzerland)2025

Length and Type of Antibiotic Prophylaxis for Infection Prevention in Adults Patient in the Cardiac Surgery Intensive Care Unit: A Narrative Review.

Raffaele Barbato, Benedetto Ferraresi, Massimo Chello, Alessandro Strumia, Ilaria Gagliardi, Francesco Loreni, Alessia Mattei, Giuseppe Santarpino, Massimiliano Carassiti, Francesco Grigioni and 1 more

Abstract readReview
In one paragraph

Review in Antibiotics (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Observational
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Raffaele BarbatoUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0009-0004-8729-655X
Benedetto FerraresiUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0009-0003-4801-0005
Massimo ChelloUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Alessandro StrumiaDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0000-0002-3505-1153
Ilaria GagliardiUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Francesco LoreniUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Alessia MatteiDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0000-0002-7571-6121
Giuseppe SantarpinoDepartment of Health Sciences, University "Magna Græcia" of Catanzaro, 88100 Catanzaro, Italy.ORCID 0000-0002-4913-9834
Massimiliano CarassitiDepartment of Anesthesia and Intensive Care, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Francesco GrigioniUnit of Cardiac Science, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.
Mario LusiniUnit of Cardiac Surgery, Department of Medicine, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy.ORCID 0000-0003-0982-0550

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInfections following cardiac surgery are a significant cause of morbidity and mortality, particularly in intensive care units (ICUs). The role of antibiotic prophylaxis (AP) in preventing surgical site infections (SSIs) and other nosocomial infections is crucial; however, the optimal approach to agent selection, dosing, and duration remains controversial.

objectiveThis narrative review aims to summarise the current evidence and expert recommendations regarding the use of perioperative antibiotic prophylaxis (AP) in adults undergoing cardiac surgery, with a particular focus on intensive care settings, transplant recipients, and adult patients on extracorporeal membrane oxygenation (ECMO).

methodsA comprehensive review of recent literature was conducted, focusing on pharmacokinetic/pharmacodynamic (PK/PD) principles, microbial epidemiology, antimicrobial resistance (AMR), and practical strategies for tailored prophylaxis in high-risk populations.

resultsCefazolin remains the first-line agent for most procedures, with vancomycin or clindamycin reserved for patients who are allergic to β-lactams or who are colonised with MRSA. Redosing is recommended in cases of prolonged surgery or cardiopulmonary bypass. Evidence supports limiting prophylaxis to ≤24 h, with a potential extension to 48 h in select high-risk cases; however, continuation beyond this is discouraged due to the risk of resistance. In heart transplantation, multimodal prophylaxis against bacteria, fungi, and viruses is essential but must be tailored to the individual patient. In the ECMO setting, the current evidence does not support the routine administration of prophylaxis (AP), and therapy should be tailored based on pharmacokinetics (PK)/pharmacodynamics (PD) changes and the clinical context. A multidisciplinary, evidence-based approach to AP in cardiac surgery is essential. Prophylaxis should be patient-specific, microbiologically guided, and limited in duration to reduce the emergence of multidrug-resistant organisms. Integrating antimicrobial stewardship, non-pharmacological measures, and rigorous surveillance is crucial for optimising the prevention of infections in this vulnerable population.

Indexed as

antibiotic prophylaxisantimicrobial resistancecardiac surgeryECMOheart transplantICUmultidrug-resistant organismsperioperative infectionpharmacokineticssurgical site infection

Identifiers

PMID41009912
PMCPMC12466373

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.