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Abstract
Serum levels of cloxacillin and benzylpenicillin were monitored in 35 consecutive adult patients undergoing elective open-heart surgery. Serial serum samples were analyzed during a 24-hour period. After oral intake of cloxacillin and phenoxymethylpenicillin on the preceding evening, very low concentrations remained in serum at the start of operation. Such preoperative medication is inappropriate. Intravenously administered cloxacillin (2 g) and benzylpenicillin (3 g) appeared to be adquate during the first 4 hours of surgery, as the serum half-life of the drugs was twice as long in the patients as in healthy adults, but repetition of the doses is recommended for further antibiotic protection during surgery.