Pre-operative Prophylaxis With Vancomycin and Cefazolin in Pediatric Cardiovascular Surgery Patients

Not Recruiting

Trial ID: NCT01619982


The investigators hope to learn 1) if the addition of prophylaxis with vancomycin will decrease the rate of cefazolin non-susceptible surgical site infections (SSI), in high risk population 2) to develop better understanding of vancomycin and cefazolin pharmacokinetics in children undergoing cardiopulmonary bypass (CPB) 3) to assess the barriers to vancomycin dosing peri-operatively 4) to assess side effects and risks associated with peri-operative vancomycin administration. This will allow us to improve patient care by better understanding the benefits or the risks of peri-operative vancomycin administration and potentially decrease cefazolin-resistant surgical site infections. In addition, this study gives us the opportunity to evaluate cefazolin and vancomycin pharmacokinetics (pK) on children on CPB. The investigators will take blood samples from 20 patients. In 10 patients the investigators will do Cefazolin pK analysis and in the other 10 the investigators will do pK Vancomycin analysis. For the remainder of 292 patients, only prospective chart review will be done to determine the incidence of SSIs. This data will be compared with 936 controls who received only Cefazolin pre-operatively as prophylaxis for SSI's. --------------------------------------------------------------------------------

Official Title

Effect of Pre-operative Prophylaxis With Vancomycin on Rate of Cefazolin Non-susceptible Gram Positive Surgical Site Infections in Cardiovascular Surgery Patients

Stanford Investigator(s)

Chandra Ramamoorthy
Chandra Ramamoorthy

Professor of Anesthesiology, Perioperative and Pain Medicine (Pediatric), Emerita


Inclusion Criteria:

   1. Patient less than or equal to 1 year of age who is undergoing cardiovascular surgery
   requiring CPB or patient under 18 years of age undergoing procedures involving aortic
   valve or aorta

   2. Patients with a positive MRSA screen or a history of MRSA infections who are
   undergoing any cardiac surgery

Exclusion Criteria:

   1. Patients who have known hypersensitivity to vancomycin or cephalosporins

   2. Patients with renal insufficiency

   3. Patients who have received vancomycin or cephalosporins 48 hours prior to the day of

   4. Patients whose surgery is due to an infection-related diagnosis such as endocarditis

   5. Patients whose parents do not wish to have them receive vancomycin prophylaxis

   6. Neonates born at less than 38 weeks gestational age


drug: Cefazolin 25 mg/kg body weight and Vancomycin hydrochloride

drug: Cefazolin 30 mg/kg body weight

Not Recruiting

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Kathleen Gutierrez, MD