Antibiotic Prophylaxis for Coronary Artery Bypass Grafting

Guideline Recommendations

• The American Society of Anesthesiologists recommends limiting antibiotic prophylaxis to the operative period, with prescription beyond this period not recommended for cardiac surgery, targeting organisms such as S. aureus, S. epidermidis, and some gram-negative bacteria 1
• The standard of care suggests that prophylaxis should generally be limited to 24 hours maximum, with the first dose administered within 60 minutes before surgical incision, ideally 30 minutes before, as recommended by the American College of Cardiology 2
• The American Heart Association also recommends that the timing of the first dose should be within 60 minutes before surgical incision, and re-dosing intraoperatively if the procedure exceeds 4 hours, with a maximum duration of 24 hours 3