To assay the efficiency of
cephalothin prophylaxis in open-heart surgery, bacteriological examination of pressure-measurement units, intravenous
catheter tips, and urine were made in 211 consecutive patients as well as blood cultures and sputum in suspected postoperative
sepsis. Furthermore,
cephalothin concentration in serum and tissue was determined in 12 consecutive adults with intact kidney function. Samples were taken before, during, and after the
cardiopulmonary bypass, the tissue from the right atrium only before and after
cardiopulmonary bypass. A high serum
cephalothin level (80.04 +/- 23.35 microgram/ml) was measured 30 min after administration of 2 g
cephalothin given as a 15-min-long i.v. infusion on induction of
anesthesia. An
antibiotic regimen - 4 X 2 g dose of
cephalothin daily (first dose on induction of
anesthesia) - provides a serum
cephalothin level which is significantly higher than the
cephalothin minimum inhibitory concentrations for most gram-positive organisms (0.475 microgram/ml) and so ensures an adequate
antibiotic coverage throughout the
surgical procedure and during the early postoperative phase of open-heart surgery.