A 62-Year-Old Man Is Hospitalized for Elective Coronary Artery Bypass

A 62-year-old man is hospitalized for elective coronary artery bypass graft surgery.  The patient had been having worsening exertional angina and was found to have 3-vessel coronary artery disease.  His other medical conditions include hypertension, type 2 diabetes mellitus, and hyperlipidemia.  He has had no infections and has not used antibiotics recently.  The patient has a history of severe penicillin allergy causing anaphylactic shock.  Blood pressure is 128/72 mm Hg and pulse is 78/min.  The lungs are clear on auscultation and heart sounds are normal.  Preoperative blood cell counts, serum chemistry, and coagulation studies are within normal limits.  Which of the following is the most appropriate preoperative prophylactic antibiotic for this patient?

A) Azithromycin
B) Ciprofloxacin
C) Metronidazole
D) Piperacillin-tazobactam
E) Vancomycin

Correct Answer:

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