Pharmacokinetics of vancomycin administered as prophylaxis before cardiac surgery

Vancomycin concentrations in serum, tissues, and sternum, administered as p rophylaxis to patients during coronary artery bypass surgery, were measured . Vancomycin (15 mg/kg) was administered to 15 patients 1 hour before skin incision. Blood, tissue, and sternum samples were collected before, during, and after bypass. The concentration in serum at the end of infusion was 55 .1 +/- 22.8 mug/mL, the mean elimination half-life was 9 +/- 4 hours, the a reas under the concentration-time curve (AUC) from 0 to 12 hours and from 0 to infinity were 90.6 +/- 25.1 and 289.7 +/- 86.5 mug/h per mi, respective ly, the mean residence time (MRT) was 11.9 +/- 5.0 hours, the mean volume o f distribution was 51.1 +/- 12.2 L, and the total clearance was 78.3 +/- 32 .6 mL/min. Vancomycin concentrations in serum, tissues, and sternum during the operation were greater than the MIC90 for most staphylococci and ranged from 16 to 55 mug/mL in serum and from 4 to 39 mug/g in sternum and tissue s.