Which of the following is NOT part of mediastinitis treatment?

• A. Oral antibiotics
• B. IV antibiotics
• C. Wound debridement
• D. Wound irrigation & dressings

Answer: (A)

Mediastinitis after CABG is a deep, life-threatening infection that requires prompt, aggressive management with IV antibiotics and surgical source control. The infection sits in necrotic mediastinal tissue where drug penetration from oral formulations is unreliable, so intravenous antibiotics with broad, appropriate coverage are essential to rapidly achieve therapeutic levels and treat a potentially polymicrobial mix. Surgical debridement removes nonviable tissue and reduces the bacterial burden, which is crucial for healing. Wound irrigation and appropriate dressings (often including negative-pressure therapy) help continue infection control and support repair of the chest wall. Oral antibiotics alone cannot reliably reach the mediastinal space or address necrotic tissue, so they are not part of the standard treatment for mediastinitis.