Antibiotic Concentration in Human Hearts

Early postoperative endocarditis is a major complication of open heart surgery particularly after valve replacement. By definition it is a clinical picture within 60 days after the initial operation due primary to staphylococcal infection. The incidence is approximately 1 % with a high mortality of between 40% and 100% (1). Contamination occurs probably intraoperative. The clinical picture develops either as a primary sepsis and endocarditis or as secondary sepsis arising from an infected sternotomy with consequent infection of blood and valves. Since general resistance is reduced during and after ECC and because many patients are of advanced age, it is generally agreed that antibiotic prophylaxis is necessary particularly if an artificial valve is implanted (2, 3). In order to find the most suitable drug it is important to know not only the antibiotic potential against different strains of bacteria but also the concentration of the administered antibiotic at the site of its intended activity.