Which of the following is the drug of choice for preoperative antibiotic prophylaxis in a patient undergoing cardiac surgery?

Options

  1. Penicillin G
  2. Erythromycin
  3. Azithromycin
  4. Cefazolin

Correct Answer

Cefazolin

Explanation

Cefazolin is the drug of choice for prophylaxis in cardiac surgery because: 1) It is a first-generation cephalosporin with excellent coverage against Staphylococcus aureus (including MSSA) and Staphylococcus epidermidis - the most common organisms causing surgical site infections in cardiac surgery, 2) It has good tissue penetration, 3) Appropriate half-life for surgical prophylaxis, 4) It should be administered within 60 minutes before skin incision. For patients with β-lactam allergy, vancomycin is an alternative.


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