Cardiothoracic & vascular anaesthesia
Antibiotic prophylaxis with vancomycin and gentamicin and the occurrence of acute kidney injury after cardiac surgery with cardiopulmonary bypass: A retrospective single-centre cohort study
Authors' conclusion
In this large retrospective cohort, VGA antibiotic prophylaxis was independently associated with increased AKI risk following cardiac surgery with CPB. This association was driven primarily by patients with preoperative risk factors for AKI. Alternative prophylactic regimens should be considered in high-risk patients when possible.
Study context
- Population
- Patients undergoing cardiac surgery with cardiopulmonary bypass (CPB), April 2013 to December 2021included, of 8895 eligible patients
- Participants
- 8,198 patients
- Exposure
- VGA prophylaxis vs cephalosporins
- VGAn = 729
- Cephalosporinsn = 7,469reference
- Outcome
- AKI (KDIGO criteria)
- Follow-up
- Within 7 postoperative days
Methodological detailsmultivariable adjustment, propensity score analysis
- Multivariable adjustment
- Propensity score analysis
Main finding
As reported in the abstract
VGA vs cephalosporinsOdds ratio (95% CI)P value
Multivariable adjustment
1.29(1.03–1.62)
P = 0.024Propensity score analysis
1.32(1.09–1.60)
P = 0.005- Overall acute kidney injury (AKI) incidence
- 16%
Observational data: associations, not effects.
Further findings
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| AKI, high-risk patients (subgroup) | 1.53 (1.14–2.04) | P = 0.004 | |
| AKI, low-risk patients (subgroup) | 1.19 (0.87–1.64) | P = 0.285 | |
| 0.512Odds ratio (log scale) |
- AKI, high-risk patients (subgroup): high-risk: insulin-dependent diabetes, cirrhosis, acute endocarditis, preoperative critical state, emergency surgery, or cardiac transplantation
Original publication
Antibiotic prophylaxis with vancomycin and gentamicin and the occurrence of acute kidney injury after cardiac surgery with cardiopulmonary bypass: A retrospective single-centre cohort study. Eur J Anaesthesiol. Published 20 October 2026. doi:10.
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