'Single-Shot'-Antibiotika-Prophylaxe in der Thoraxchirurgie

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Thoracic surgery is associated with a high risk of infection complications, leading to the common practice of antibiotic prophylaxis (APr). However, the significant benefits of APr remain unproven. In a randomized controlled trial involving 200 patients, a single-shot APr with 1.5 grams of cefuroxime was administered, with 100 patients in each group. Results showed that post-operative infections—wound, pleural, urinary tract, and pneumonia—were less frequent in the APr group. Bacteriological tests indicated a notable reduction in existing tracheo-bronchial germs and prevention of new colonization related to intubation. Consequently, antibiotic therapy was less common in the APr group, leading to overall lower costs. Chest radiographs revealed significantly better outcomes for infiltrate signs in the APr group, with frequency and severity correlating with leukocyte counts and gas exchange metrics, indicating inflammatory lung changes. Defined risk factors such as malignancy, age, smoking, obesity, and positive germ detection showed significant correlations with infiltrate signs. Notably, non-risk patients gained the most benefit from APr, while the control group exhibited a statistically independent risk for pneumonia. In conclusion, a single-shot APr offers clinical advantages in thoracic surgery and demonstrates the potential for effective prophylaxis against colonization and infection in tracheal and pulmonary surfaces.