Pharmacokinetics of vancomycin in serum and tissue of patients undergoing open-heart surgery

Penetration of vancomycin into serum, heart valves, subcutaneous tissue and muscle was determined in 33 adult patients undergoing open-heart surgery. Each patient received 15 mg/kg vancomycin as a 30-min intravenous infusion preoperatively. Within 6 h vancomycin plasma concentrations declined from 28.9 to 4.2 mg/l. Vancomycin concentrations decreased in subcutaneous tissue slowly and varied in muscle between 1.2 and 3.2 mg/kg, in subcutaneous tissue between 1.3 and 4.4 mg/kg and in heart valves between 2.3 and 4.2 mg/kg. Vancomycin concentrations in heart valves are high enough to inhibit most oxacillin-resistant Staphylococcus aureus, and coagulase-negative staphylococci causing postoperative wound infections and endocarditis.