Copyright © 1992, American Society for Microbiology Penetration of Vancomycin in Uninfected Sternal Bone

Concentrations of vancomycin in sternal bones of 10 patients undergoing cardiac surgery were studied at steady state, 48 h after starting intravenous prophylaxis. A sample of sternal bone was taken before (group I) or after (group II) cardiopulmonary bypass. The mean vancomycin concentrations in sternal bones were not significantly different between the groups and were 9.3 ± 3.0 pg/g. The concentrations ofvancomycin in sternal bones were always above the MICs for staphylococci, streptococci, and enterococci. Antibiotic prophylaxis is widely used in cardiac surgery. Methicillin-resistant coagulase-negative staphylococci are among the most common pathogens in this setting, and vancomycin is increasingly being used in patients with infections due to both coagulase-negative and coagulase-positive strains, indwelling devices, and immunosuppres-sion. Vancomycin could be an alternative to cephalosporins (cefazolin and cefamandole) for prophylaxis during cardiac operations in allergic patients or when there are significant numbers of methicillin-resistant coagulase-negative staph