Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery

Mohammad R Movahed, Babak Kasravi, Charles S. Bryan

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

The recent appearance of Staphylococcus aureus and Staphylococcus epidermidis strains that have reduced susceptibility to vancomycin, and the spread of vancomycin-resistant enterococci, raise the specter of endovascular infections that will be difficult or impossible to cure with available drugs. We review issues concerning the prophylactic use of vancomycin in adult cardiology and cardiac surgery with special attention to dosing and indications. There is no indication for the routine use of prophylactic vancomycin in pacemaker implantations, cardiac catheterization, and transesophageal echocardiography. In institutions with a high incidence of methicillin-resistant S. aureus and S. epidermidis, vancomycin may be used for antibiotic prophylaxis in place of cephalosporins for pacemaker or defibrillator implantation. The strongest evidence in support of the prophylactic use of vancomycin is during cardiac surgeries, particularly valvular surgeries in institutions with a high prevalence of methicillin-resistant S. aureus and S. epidermidis. When vancomycin is used prior to open heart surgery, the dose should be 15 mg/kg rather than the standard 1 g dose that is often recommended in the literature and used by 85% of institutional pharmacists who responded to our survey. Cardiologists and cardiac surgeons should assume leadership roles in promoting its responsible use.

Original languageEnglish (US)
Pages (from-to)13-20
Number of pages8
JournalJournal of Cardiovascular Pharmacology and Therapeutics
Volume9
Issue number1
StatePublished - Mar 2004
Externally publishedYes

Fingerprint

Vancomycin
Cardiology
Thoracic Surgery
Staphylococcus epidermidis
Methicillin-Resistant Staphylococcus aureus
Defibrillators
Antibiotic Prophylaxis
Transesophageal Echocardiography
Cephalosporins
Cardiac Catheterization
Pharmacists
Staphylococcus aureus
Incidence
Infection
Pharmaceutical Preparations

Keywords

  • Cardiac surgery
  • Cardiology
  • Endocarditis
  • Prophylaxis
  • Vancomycin

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

Prophylactic Use of Vancomycin in Adult Cardiology and Cardiac Surgery. / Movahed, Mohammad R; Kasravi, Babak; Bryan, Charles S.

In: Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 9, No. 1, 03.2004, p. 13-20.

Research output: Contribution to journalArticle

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