Zibari GB, Gadallah MF, Landreneau MD, McMillan R, Bridges R,
Costley K, Work J, McDonald JC
Preoperative vancomycin prophylaxis decreases the incidence of
hemodialysis vascular access infections
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Nov) 6:570 1995
In 408 vascular access procedures (56% primary, 44% secondary)
randomly assigned to preop vancomycin (750 mg 12-24 hours pre-op)
or nothing, the infection rate was 1% in the vanco-pretreated
group vs. 6% in controls.
Comment:
In this period of increasing appearance of vancomycin-resistant
enterococci and other "superbugs", the widespread use of
vancomycin has been called into question. The benefits of this
pre-op strategy (which only affected 2.5% of patients receiving
vancomycin) needs to be balanced against the risk of encouraging
emergence of such resistant strains of micro-organisms.
(Daugirdas)
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Am Soc Nephrol
CRF by problem area :
Infections (other than hepatitis, peritonitis)
Basic hemodialysis :
Vascular Access: graft/fistula