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Volume 7, Number 5—October 2001
Research

Clinical Consequences and Cost of Limiting Use of Vancomycin for Perioperative Prophylaxis: Example of Coronary Artery Bypass Surgery

Giorgio Zanetti*†Comments to Author , Sue J. Goldie‡, and Richard Platt*§
Author affiliations: *Channing Laboratory, Brigham and Women's Hospital, and Eastern Massachusetts CDC Prevention Epicenter, Boston, Massachusetts, USA; †University Hospital, Lausanne, Switzerland; ‡Harvard School of Public Health, Boston, Massachusetts, USA; §Harvard Medical School and Harvard Pilgrim Health Care, Boston, Massachusetts, USA

Main Article

Table 2

Base-case analysis: clinical outcomes and costs for a hypothetical cohort of 10,000 patients undergoing coronary artery bypass graft surgery

Strategy Deep SSI Increm. deep SSIa Superficial SSI Increm. superficial SSIa Hospital deaths Increm. hospital deathsa Deaths, SSI, or both Increm. deaths, SSI, or both Costs (x $1,000) Increm. costs (x $1,000)a
No prophylaxis 570 - 1,141 - 405 - 2,008 - 33,410 -
Routine cefazolin 397 - 173‡ 794 - 347b 391 - 14b 1,506 - 502b 24,530 - 8,880b
Routine vancomycin 368 - 29b 736 - 58b 388 - 3b 1,423 - 83b 23,360 - 1,170b

SSI = surgical site infection; increm = incremental.
aRoutine cefazolin compared with no prophylaxis; routine vancomycin compared with routine cefazolin.
bNegative incremental numbers of infections or deaths represent the numbers of infections or deaths averted; negative incremental costs represent costsaving.

Main Article

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