Gentamicin in Cardiac Surgery

NCT ID: NCT06454643

Last Updated: 2024-06-12

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

50 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-01-01

Study Completion Date

2021-01-01

Brief Summary

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Surgical site infection (SSI) is a serious postoperative complication after cardiac surgery that have a negative impact on a patient's health and survival. This study aims to investigate the effectiveness of administering gentamicin in reducing the incidence of SSI with monitoring to the effective therapeutic level.

Detailed Description

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Gentamicin is an aminoglycoside antibiotic that exhibits a wide range of antibacterial effects, mostly targeting Gram-negative bacteria, while its effectiveness against Gram-positive organisms is comparatively weaker. Gentamicin has significant efficacy against multidrug-resistant bacteria as well. Gentamicin is often used in conjunction with beta-lactam antibiotics to provide enhanced therapeutic efficacy via a synergistic effect, particularly in cases of Gram-positive and multidrug-resistant bacterial infections.

This study aims to evaluate the efficacy of administering gentamicin in combination with flucloxacillin as a pre-medication and for 48 hours after surgery in reducing the incidence of surgical site infections in patients undergoing cardiac surgeries, as compared to using a combination of ceftriaxone and flucloxacillin. Additionally, the study aimed to observes the therapeutic level of gentamicin required to achieve an effective concentration of the drug.

A prospective comparative study was conducted using an appropriate sample of 50 Iraqi patients undergone several types of cardiac surgeries.

A total of 50 patients (34 males and 16 females) between the ages of 18 and 75 were included in this study. These patients were admitted to the Surgical Department of the Iraqi Center for Heart Disease over a one-year period from January 2020 to January 2021. All patients underwent various types of cardiac surgery, such as coronary artery bypass graft (CABG), valve replacement, or device placement. The same surgical and anesthesia teams conducted the procedures.

A computerized randomization method was used to allocate patients into two groups in a randomized manner. Following the first interview, the patients were sequentially assigned numbers and then randomized into two groups via the online program Research Randomizer

Conditions

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Cardiac Infection

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

PREVENTION

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Control

Patients received flucloxacillin and ceftriaxone 60 minute before incision and then continued for 48 hours as follows:

* Flucloxacillin 2g given before surgery then 1g \* 4 for 48 hours after operation.
* Ceftriaxone 1g given before surgery then 1g \* 2 for 48 hours after operation.

Group Type ACTIVE_COMPARATOR

Flucloxacillin and ceftriaxone

Intervention Type DRUG

Control group

Gentamicin

Patients received flucloxacillin and gentamicin 60 minute before incision and then continued for 48 hours, as follows:

* Flucloxacillin 2g given before surgery then 1g \* 4 for 48 hours after operation.
* Gentamicin 2mg/kg of ideal body weight given before surgery, then 80 mg \*3 for 48 hours after surgery.

Group Type EXPERIMENTAL

Flucloxacillin and gentamicin

Intervention Type DRUG

This intervention aimed to investigate the effectiveness of administering gentamicin in reducing the incidence of SSI.

Interventions

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Flucloxacillin and gentamicin

This intervention aimed to investigate the effectiveness of administering gentamicin in reducing the incidence of SSI.

Intervention Type DRUG

Flucloxacillin and ceftriaxone

Control group

Intervention Type DRUG

Eligibility Criteria

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Inclusion Criteria

* The research included individuals of both genders.
* Patients aged 18 and above.
* Patients had undergone any type of cardiac surgery.

Exclusion Criteria

* Patients having a prior diagnosis of organ failure.
* Patients already on antibiotics.
* Patients with elevated baseline renal function test before operation.
* Patients with contraindications to any of the prescribed medications were excluded from this study.
Minimum Eligible Age

18 Years

Maximum Eligible Age

75 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Al-Rasheed University College

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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Baghdad Medical City

Baghdad, , Iraq

Site Status

Countries

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Iraq

References

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Ackah JK, Neal L, Marshall NR, Panahi P, Lloyd C, Rogers LJ. Antimicrobial prophylaxis in adult cardiac surgery in the United Kingdom and Republic of Ireland. J Infect Prev. 2021 Mar;22(2):83-90. doi: 10.1177/1757177420971850. Epub 2020 Nov 24.

Reference Type RESULT
PMID: 33859725 (View on PubMed)

White RW, West R, Howard P, Sandoe J. Antimicrobial regime for cardiac surgery: the safety and effectiveness of short-course flucloxacillin (or teicoplanin) and gentamicin-based prophylaxis. J Card Surg. 2013 Sep;28(5):512-6. doi: 10.1111/jocs.12155. Epub 2013 Jul 9.

Reference Type RESULT
PMID: 23837413 (View on PubMed)

Other Identifiers

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AR200311

Identifier Type: -

Identifier Source: org_study_id

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