IS SINGLE-DOSE ANTIBIOTIC-PROPHYLAXIS SUFFICIENT FOR CORONARY-ARTERY BYPASS-SURGERY - AN ANALYSIS OF PERIOPERATIVE AND POSTOPERATIVE SERUM CEFUROXIME AND VANCOMYCIN LEVELS

Preliminary findings have suggested that a single intravenous dose of antibiotic is effective for infection prophylaxis in cardiac surgery. However there are still insufficient data on this proposed regimen. We measured serum cefuroxime and vancomycin levels after three different dosage regimens, in patients undergoing coronary artery bypass grafti ng (CABG). Sixty patients were randomized into three cefuroxime and th ree vancomycin groups with 10 patients in each: a group given a one-da y course, or an additional dose during cardiopulmonary bypass ol a sin gle dose. Serum levels of the antibiotics were measured at various lim es throughout the operative procedure and until 48 h after the start o f prophylaxis. Each of the six dosage regimens maintained serum levels adequate for infection prophylaxis throughout the operative procedure . Serum levels remained above 2 mg/L for more than 8 h postoperatively , even in the single-dose cefuroxime group and above 4 mg/L for more t han 24 h with all the vancomycin dosage regimens. Thus a single dose o f cefuroxime (3 g or 1.5 g) or vancomycin (1.5 g) seems to achieve and maintain serum levels sufficient for infection prophylaxis several ho urs after CABG procedures.