Vancomycin blood levels during cardiac bypass surgery

Because of the allergic reaction that some patients have to penicillin and cephalosporins, there is a need for an alternative antimicrobial agent to protect the patient who undergoes coronary artery bypass grafting from infection perioperatively. Vancomycin, a bactericidal antibiotic active against gram-positive organisms was studied in 13 men who underwent aortocoronary bypass grafting. For 60 minutes from the time the patient arrived in the operating room, vancomycin (15 mg/kg) was given intravenously. Blood levels were assayed up to 12 hours thereafter. Adequate antistaphylococcal levels of the drug were maintained throughout operation. Twelve hours later levels were subtherapeutic. There was no cardiovascular, cutaneous or renal toxicity. Two patients had minor wound infections.