Whether 3.0 g cefuroxime prophylaxis before cardiac surgery diminished postoperative pneumonia and persistent fever compared with 1.5 g: a nested case-control study

Objectives Whether 3.0 g CXM prophylaxis before cardiac surgery can effectively avoid POP and persistent POFcompared with 1.5 g is debatable, which needs to be confirmed by evidence medical research. Methods A total of 301 patients who underwent CXM prophylaxis before cardiac surgery from Jan 2023 to Dec 2023 at the First Affiliated Hospital of Nanjing Medical University were incorporated in a nested case-control study. The patients were divided into the 1.5 g (n=170) and 3.0 g (n=131) groups according to the dosage of prophylactic CXM. Outcomes included POP and persistent POF. Risk andstratification analysis was performed for the effect andmodification of different doses of CXM on outcomes. Results The incidence of persistent POF in 1.5 g group (52, 30.59%) was lower than that in 3.0 g group (67, 51.15%) unadjusted (OR=2.38, 95% CI :1.48~3.81, P< 0.001) or adjusted (OR=2.38, 95% CI :1.36~4.14, P =0.002) for the confounding variables. There was no significant difference in POP between the two groups unadjusted (OR=1.26, 95% CI :0.62~2.55, P =0.522) or adjusted (OR=1.03., 95% CI :0.48~2.20, P =0.945) for the confounding variables. The results of stratification analysis defined that two different dosages of prophylactic CXM didn’t generate effect modification on the risk factors of persistent POF. Conclusions 3.0 g CXM prophylaxis before cardiac surgery didn’t decrease the incidence of POP but increased the risk of persistent POF compared with 1.5 g. Given the facts, this study may point the solution of CXM preoperative prophylaxis for cardiac surgery.