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The Journal of Thoracic and Cardiovascular Surgery, Vol 85, 933-935, Copyright © 1983 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Vancomycin prophylaxis in cardiac operations: determination of an optimal dosage regimen

BF Farber, AW Karchmer, MJ Buckley and RC Moellering Jr

Vancomycin is thought to be an acceptable alternative prophylactic antibiotic to the cephalosporins in penicillin allergic patients undergoing cardiopulmonary bypass. We studied the pharmacokinetics of vancomycin in 10 patients undergoing cardiopulmonary bypass. Our results suggest that the commonly used 500 mg dose (7 mg/kg) of vancomycin given preoperatively may provide serum concentrations during cardiopulmonary bypass which are not bactericidal for many S. epidermidis strains. Thus we believe that a higher initial dose, at least 15 mg/kg, should be given.


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