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Vancomycin blood levels during cardiac bypass surgery

T W Austin, J Leake, J C Coles

Canadian Journal of Surgery. Journal Canadien De Chirurgie

|July 1, 1981

Summary

Vancomycin is a potential alternative antibiotic for patients undergoing coronary artery bypass grafting (CABG) due to penicillin allergies. While it maintained adequate levels during surgery, levels became subtherapeutic by 12 hours post-operation.

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Area of Science:

Pharmacology
Infectious Diseases
Cardiovascular Surgery

Background:

Penicillin and cephalosporin allergies necessitate alternative prophylactic antibiotics for coronary artery bypass grafting (CABG).
Gram-positive organisms are a common cause of surgical site infections following cardiac procedures.

Purpose of the Study:

To evaluate the efficacy and safety of vancomycin as a perioperative antimicrobial agent in patients undergoing CABG.

Main Methods:

A study involving 13 male patients undergoing CABG.
Intravenous administration of vancomycin (15 mg/kg) upon arrival in the operating room.
Assay of blood vancomycin levels up to 12 hours post-administration.

Main Results:

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Adequate antistaphylococcal vancomycin levels were maintained throughout the surgical procedure.

Vancomycin blood levels were subtherapeutic by 12 hours post-administration.

No significant cardiovascular, cutaneous, or renal toxicity was observed; two patients experienced minor wound infections.

Conclusions:

Vancomycin demonstrates potential as an alternative prophylactic antibiotic for CABG patients with beta-lactam allergies.
Further research is needed to optimize dosing and duration for sustained therapeutic levels and infection prevention.