***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Abstract To compare efficacy , tolerability , and cost of antibiotic prophylaxis with teicoplanin and cefazolin in clean prosthetic vascular surgery , a r and omized , prospect i ve , double-blind study was performed at the Vascular Surgery Unit of a tertiary-care university hospital . Two-hundred thirty-eight consecutive patients undergoing elective , clean , abdominal or lower-limb prosthetic vascular surgery were allocated to receive a single intravenous dose of teicoplanin ( 400 mg ) or cefazolin ( 2 g ) at the induction of anesthesia . Surgical-site infections occurred in 5.9 % of teicoplanin recipients ( 4.2 % wound infection , 1.7 % graft infection ) and 1.7 % of cefazolin recipients ( 1.7 % wound infection , 0 % graft infection ) ( P=0.195 ) . Other postoperative infections occurred in 10 % of teicoplanin recipients ( pneumonia 7 % , urinary tract infection 3 % ) and 12 % of cefazolin recipients ( pneumonia 7 % , urinary tract infection 2.5 % , bloodstream infections 2.5 % ) . Overall mortality rate was 3.4 % in teicoplanin recipients ( 4 patients ) and 2.5 % in cefazolin recipients ( 3 patients ) . Infective deaths occurred in one patient for each group . The two prophylactic regimens were well tolerated . Cost savings of US $ 52 510 favoring cefazolin were related to the lower acquisition cost ( US $ 1034 vs US $ 4740 ) and to the shorter duration of the hospital stay ( 1762 days vs 1928 days ) . Cefazolin can still be regarded as the drug of choice for prophylaxis in clean vascular surgery A total of 272 patients were enrolled into this prospect i ve , unblinded , r and omized comparison of single-dose teicoplanin vs three doses of cephradine plus metronidazole as prophylaxis for vascular surgery at St James 's and Seacroft Hospitals , Leeds , UK . In all , 71.3 % of patients ( 194/272 ) were enrolled at St James 's University Hospital . Patients received either a single dose of teicoplanin , 6 mg/kg i.v . , or cephradine , 1 g i.v . with metronidazole , 1 g rectally , at induction of anaesthesia followed by two further 1 g doses of cephradine and metronidazole 8 and 16 hours later . There were 136 patients in each treatment group . The most common operations were femoropopliteal grafts ( 96 ) and aortic aneurysm repairs ( 47 ) . In the ' intention-to-treat ' analysis , primary wound infections were seen in 4.4 % of patients ( 6/136 ) receiving teicoplanin and 5.9 % of patients ( 8/136 ) receiving cephradine plus metronidazole ( 95 % CI -6.7 % , + 3.8 % ) . Other disturbances to wound healing occurred in 23 patients ( 11 in the teicoplanin and 12 in the cephradine plus metronidazole group ) . Secondary respiratory tract infections occurred in 17 patients ( 8 receiving teicoplanin and 9 receiving cephradine plus metronidazole ) . In the evaluable patients analysis , primary wound infections occurred in 3.5 % of patients ( 4/114 ) receiving teicoplanin and 5.1 % of patients ( 6/117 ) receiving cephradine plus metronidazole .  Staphylococcus aureus and Proteus sp. were the most common pathogens in primary wound infections . Despite the absence of Gram-negative cover in the teicoplanin group , Gram-negative infections occurred more often in the cephradine plus metronidazole group . Surgery of the lower extremities carried the highest risk of post-operative infection . Rates of infection were significantly higher at Seacroft Hospital ( P = 0.001 ) , and significantly higher for cephradine plus metronidazole between the two hospitals ( P = 0.0008 ) . Adverse events occurred in 40 patients receiving teicoplanin ( 29.4 % ) and 39 patients receiving cephradine plus metronidazole ( 28.7 % ) . In 19 patients receiving teicoplanin ( 14 % ) and 15 receiving cephradine plus metronidazole ( 11 % ) these events were considered to be related to the study drugs . The most often reported events were infections , cardiac events and vascular phenomena ( haematoma or emboli ) . Marked changes in haematological parameters and liver function tests were noted seven days after operation in patients in each treatment group , but these resolved quickly as the effects of the operation subsided . ESR remained elevated in both groups at the six-month follow-up assessment . It is concluded from this two-centre study that a single dose of teicoplanin shows similar efficacy to a three-dose regimen of cephradine plus metronidazole as prophylaxis for wound infection in vascular surgery . Both regimens were well tolerated , and there was an equal incidence of adverse events in the two regimens , which reflected the poor general health status of this elderly study population Twenty-one patients undergoing elective surgery for abdominal aortic aneurysm were r and omly assigned to receive 2 grams of dicloxacillin as an intravenous infusion either at the induction of anaesthesia , 3 hours or approximately 6 hours before surgery . Sample s from serum and aortic tissue were simultaneously obtained so that antibiotic levels could be compared as a function of time . High concentrations of dicloxacillin in serum and aortic tissue were present already shortly after infusion and active levels were maintained in aortic tissue for approximately six hours . The kinetics of dicloxacillin was similar in serum and aortic tissue . These results support the need for antibiotic administration shortly before surgery to ensure adequate tissue levels of antibiotics Vascular reconstructive surgery with the placement of prosthetic material caudal to the diaphragm is occasionally associated with  postoperative wound infection .  These infections often lead to amputation and can be lethal . Only a few published reports contain information on the value of prophylactic antibiotic treatment with these operations , but its use is common throughout the world . To investigate this problem , a prospect i ve , double blind , r and omized study of vancomycin versus placebo in 128 vascular graft operations caudal to the diaphragm was conducted from June , 1982 to July , 1984 . The difference in infection rate was significant ( 2 p = 0.0008 ) in favor of the vancomycin group . Fourteen wound infections ( 21.2 % ) were found in the placebo group , 3 of which ( 4.5 % ) were prosthesis infections . Among the 62 vancomycin-treated patients , one case of superficial wound infection ( 1.6 % ) and no cases of prosthesis infection were found . The most common pathogen was Staphylococcus aureus . The study has demonstrated that vancomycin , a narrow spectrum antibiotic , in an ultra-short regimen ( one gram one hour before surgery and one gram 4 hours later ) is an effective prophylactic agent against postoperative wound infection . Temporary and , in most cases , doses-related side effects were seen in 7.9 % of the patients treated with vancomycin In 300 reconstructive arterial operations of the abdominal aorta and the lower limbs , a r and omized prospect i ve study of the effect of perioperative infection prophylaxis with antibiotics was performed . The evaluation was carried out with regard to the frequency of severe postoperative wound infections . As prophylactic antibiotic Cefuroxime was initially used , Cefotaxim was later administered . Cefotaxim has been proven to be the appropriate antibiotic against the special microbial spectrum of our clinic . Side effects or complications due to the antibiotics were not found . Wound infections of all grade s of seriousness occurred in the group without infection prophylaxis in 15.1 % , in the antibiotic group in 3 % ( p less than 0.001 ) . Serious wound infection endangering or involving the transplant were found in the group without prophylaxis in 7.2 % , whereas in the antibiotic group in 1.5 % . Infections of the vascular prosthesis were observed in 2.4 % and 0.8 % respectively . Most wound infections occurred in the groin . The most common infecting organisms were Staphylococcus aureus or epidermidis . A higher risk of wound infections due to old age or gangrene could not be observed . Although wound infections in peripheral vascular surgery are relatively rare , they have severe consequences . It is therefore advisable to administer perioperative infection prophylaxis which significantly reduces this complication , especially in patients with synthetic implants 50 patients undergoing elective vascular surgery were r and omized to prophylactic antibiotic treatment with ampicillin 2 g X 4 + cloxacillin 1 g X 4 for 4 d following the operation , or to a control group without antibiotics . All patients received heparin subcutaneously 5000 IU X 2 , for 7 d. On days 1 and 4 after the operation , the median bleeding time was 1 1/2 - 2 min longer in the antibiotics group . 5 patients on antibiotics had a bleeding time prolongation beyond the normal range , but only 2 of these , who had additional haemostatic defects , had abnormal bleeding In a prospect i ve r and omized double-blind study of 141 patients referred for reconstructive vascular surgery on the abdominal aorta and the lower extremities , placebo was compared to antibiotic prophylaxis . The prophylaxis group received three doses of a combination of methicillin , 2 g and netilmicin , 200 mg . Antibiotic prophylaxis reduced postoperative wound infections as compared to placebo , i.e. 4/69 ( 5.8 % ) vs. 12/72 , ( 16.7 % ) respectively ( P = 0.04 ) . No graft infections occurred . Two cases of postoperative septicaemia were seen in the placebo group , none in the antibiotic group . Among different procedures aortic-femoral bypass operations showed the highest wound infection rates . The two treatment groups were comparable with regard to all other postoperative complications registered , including nephro- and ototoxicity . The antibiotic regimen was considered safe , but had only marginal value as prophylaxis in vascular reconstructive surgery on the abdominal aorta and the lower extremities In a r and omized clinical study , 141 patients who had to undergo operations on the aorta or the main arteries received either amoxycillin/clavulanate or cefoxitin perioperatively for prophylaxis . As no wound infection occurred amoxycillin/clavulanate and cefoxitin were found to be equal in effectiveness BACKGROUND This r and omized clinical trial compares the incidence of wound infection after vascular surgery in patients who received prophylaxis using the same antibiotic as either a single-dose or a multiple-dose regimen ( until the lines/drain tubes were removed , but not for more than 5 days ) . METHODS Each of the 302 patients who entered the study received ticarcillin 3.0 g/clavulanate 0.1 g ( Timentin ) intravenously immediately after the induction of anesthesia . Patients r and omized to the multiple-dose group received an average of 14.3 doses ( range 9 to 20 ) . RESULTS The incidence of wound infections was 18 % ( 28 of 153 ) for patients in the single-dose group and 10 % ( 15 of 149 ) for patients in the multiple-dose group ( P = 0.04 ; relative risk estimate = 2.00 , 95 % confidence interval = -1.02 to 3.92 ) . CONCLUSIONS A multiple-dose antibiotic regimen , rather than single-dose therapy , provides optimal prophylaxis against wound infection for patients undergoing vascular surgery OBJECTIVES To test the hypothesis that oral ciprofloxacin is equally effective as intravenous cefuroxime in preventing postoperative infectious complications in patients undergoing peripheral arterial surgery involving the groins . DESIGN Prospect i ve , r and omised , double-blind multicentre study . MATERIAL S 580 patients undergoing arterial surgery involving the groins were r and omised to ciprofloxacin ( Ciproxin , Bayer ) 750 mg x 2 p.o . or cefuroxime ( Zinacef , Glaxo ) 1.5 g x 3 i.v . given only on the day of surgery . The primary endpoint was wound/graft infection within 30 days postoperatively . Wound infection was defined as pus . RESULTS The wound infection rate in the ciprofloxacin group was 9.2 % ( 27 patients ) and in the cefuroxime group 9.1 % 
    Output:
    
There is clear evidence of the benefits of prophylactic broad spectrum antibiotics .
Many other interventions intended to reduce the risk of infection in arterial reconstruction lack evidence of effectiveness