Reply to Sartipy

Reply to Sartipy 1298 Letters to the Editor / European Journal of Cardio-Thoracic Surgery [6] Olsson DP, Holzmann MJ, Sartipy U. Antibiotic prophylaxis by teicoplanin detrimental effects of vancomycin on kidney function in additional ways be- and risk of acute kidney injury in cardiac surgery. J Cardiothorac Vasc yond our relatively crude assessment of maximal postoperative creatinine lev- Anesth 2015;29:626–31. els and the need for haemodialysis. Future studies on combining vancomycin with the standard beta-lactam prophylaxis should indeed assess renal function in detail. However, it was not the primary objective of our pre- and postinter- *Corresponding author. Heart and Vascular Theme, Karolinska University vention study to weigh vancomycin against renal impairment secondary to Hospital, 17176 Stockholm, Sweden. Tel: +46-8-51772894; fax: +46-8-331931; this glycopeptide antibiotic [2]. Instead, we focused on the main outcome of e-mail: Ulrik.Sartipy@karolinska.se (U. Sartipy). sternal wound infections, which cause enormous morbidity and costs in car- diac surgery. Also, given that high-risk patients in our study received only a doi:10.1093/ejcts/ezx490 single dose of vancomycin, it can be assumed that the effect on renal function Advance Access publication 2 January 2018 will be minor, even if measured with dedicated tools. Although we agree with Dr Sartipy on the balanced view of the benefit of antibiotics against their side effects, we believe that our study demonstrates that the much-feared infec- tious complication in cardiac surgery can be reduced. REFERENCES a, b Lars Englberger * and Jonas Marschall Department of Cardiovascular Surgery, Bern University Hospital, University [1] Sartipy U. Vancomycin prophylaxis and acute kidney injury after cardiac of Bern, Bern, Switzerland surgery. Eur J Cardiothorac Surg 2018;53:1297–8. Department of Infectious Diseases, Bern University Hospital, University of [2] Reineke S, Carrel TP, Eigenmann V, Gahl B, Fuehrer U, Seidl C et al. Adding Bern, Bern, Switzerland vancomycin to perioperative prophylaxis decreases deep sternal wound in- fections in high-risk cardiac surgery patients. Eur J Cardiothorac Surg Received 11 December 2017; accepted 15 December 2017 2018;53:428–34. Keywords: Cardiac surgery � Acute kidney injury � Antibiotic prophylaxis � Vancomycin *Corresponding author. Department of Cardiovascular Surgery, Bern University Hospital, Freiburgstrasse, 3010 Bern, Switzerland. Tel: +41-31-6322376; fax: We appreciate the response to our research by Dr Sartipy [1, 2]. He raises an +41-31-616324443; e-mail: lars.englberger@insel.ch (L. Englberger). important point in arguing for a balanced view of our conclusion that adding vancomycin to perioperative prophylaxis in high-risk patients undergoing car- doi:10.1093/ejcts/ezx491 diac surgery is beneficial. Specifically, he argues for measuring the potential Advance Access publication 2 January 2018 Downloaded from https://academic.oup.com/ejcts/article-abstract/53/6/1298/4782689 by Ed 'DeepDyve' Gillespie user on 20 June 2018 http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png European Journal of Cardio-Thoracic Surgery Oxford University Press
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Publisher
Oxford University Press
Copyright
© The Author(s) 2018. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
ISSN
1010-7940
eISSN
1873-734X
D.O.I.
10.1093/ejcts/ezx491
Publisher site
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Abstract

1298 Letters to the Editor / European Journal of Cardio-Thoracic Surgery [6] Olsson DP, Holzmann MJ, Sartipy U. Antibiotic prophylaxis by teicoplanin detrimental effects of vancomycin on kidney function in additional ways be- and risk of acute kidney injury in cardiac surgery. J Cardiothorac Vasc yond our relatively crude assessment of maximal postoperative creatinine lev- Anesth 2015;29:626–31. els and the need for haemodialysis. Future studies on combining vancomycin with the standard beta-lactam prophylaxis should indeed assess renal function in detail. However, it was not the primary objective of our pre- and postinter- *Corresponding author. Heart and Vascular Theme, Karolinska University vention study to weigh vancomycin against renal impairment secondary to Hospital, 17176 Stockholm, Sweden. Tel: +46-8-51772894; fax: +46-8-331931; this glycopeptide antibiotic [2]. Instead, we focused on the main outcome of e-mail: Ulrik.Sartipy@karolinska.se (U. Sartipy). sternal wound infections, which cause enormous morbidity and costs in car- diac surgery. Also, given that high-risk patients in our study received only a doi:10.1093/ejcts/ezx490 single dose of vancomycin, it can be assumed that the effect on renal function Advance Access publication 2 January 2018 will be minor, even if measured with dedicated tools. Although we agree with Dr Sartipy on the balanced view of the benefit of antibiotics against their side effects, we believe that our study demonstrates that the much-feared infec- tious complication in cardiac surgery can be reduced. REFERENCES a, b Lars Englberger * and Jonas Marschall Department of Cardiovascular Surgery, Bern University Hospital, University [1] Sartipy U. Vancomycin prophylaxis and acute kidney injury after cardiac of Bern, Bern, Switzerland surgery. Eur J Cardiothorac Surg 2018;53:1297–8. Department of Infectious Diseases, Bern University Hospital, University of [2] Reineke S, Carrel TP, Eigenmann V, Gahl B, Fuehrer U, Seidl C et al. Adding Bern, Bern, Switzerland vancomycin to perioperative prophylaxis decreases deep sternal wound in- fections in high-risk cardiac surgery patients. Eur J Cardiothorac Surg Received 11 December 2017; accepted 15 December 2017 2018;53:428–34. Keywords: Cardiac surgery � Acute kidney injury � Antibiotic prophylaxis � Vancomycin *Corresponding author. Department of Cardiovascular Surgery, Bern University Hospital, Freiburgstrasse, 3010 Bern, Switzerland. Tel: +41-31-6322376; fax: We appreciate the response to our research by Dr Sartipy [1, 2]. He raises an +41-31-616324443; e-mail: lars.englberger@insel.ch (L. Englberger). important point in arguing for a balanced view of our conclusion that adding vancomycin to perioperative prophylaxis in high-risk patients undergoing car- doi:10.1093/ejcts/ezx491 diac surgery is beneficial. Specifically, he argues for measuring the potential Advance Access publication 2 January 2018 Downloaded from https://academic.oup.com/ejcts/article-abstract/53/6/1298/4782689 by Ed 'DeepDyve' Gillespie user on 20 June 2018

Journal

European Journal of Cardio-Thoracic SurgeryOxford University Press

Published: Jan 2, 2018

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