Pharmacokinetics and tissue penetration of a single dose of ceftriaxone (1,000 milligrams intravenously) for antibiotic prophylaxis in thoracic surgery

Abstract

The pharmacokinetics and tissue penetration of ceftiaxone after a single intravenous injection of 1,000 mg to 17 patients for antibiotic prophylaxis in thoracic surgery were studied. The patients were scheduled for elective noncardiac thoracic surgery. Adequate levels in serum (higher than Noncardiac thoracic surgery is "contaminated-aseptic surgery" in most cases (4,6,7,11). Antibiotic prophylaxis is used against pathogens most likely to contaminate the surgical wound: Escherichia coli, various members of the family Enterobacteriaceae, Streptococcus spp., Haemophilus influenzae, Staphylococcus aureus, and Pseudomonas spp. (4,6,7,11 Ceftriaxone concentrations were determined by high-performance liquid chromatography (HPLC) (19), with a normal-phase technique and an NH-bonded-phase column (Spherisorb C18 Waters; 100 mm; 5-pm internal diameter).The mobile phase was a combination of acetonitrile (50 ml)

Timing of surgical antimicrobial prophylaxis: a phase 3 randomised controlled trial

“…In 1961, Burke [43] showed the timing of SAP to be crucial in animals. Subsequent studies in humans suggested that adequate tissue levels of an appropriate antibiotic during surgery were essential [21,[44][45][46][47].…”

Penetration of Ertapenem Into Different Pulmonary Compartments of Patients Undergoing Lung Surgery

“…The highest ELF concentrations were achieved 1 hour after infusion (4.06 ± 6.64 mg/L), and the highest mean level of ELF penetration was 9.40% 5 hours after infusion. However, in comparison to ceftriaxone, another antimicrobial drug used frequently for treatment of CAP, ertapenem concentrations in lung tissue were much lower (7.60 ± 4.85 mg/kg vs 27.0 ± 9.00 mg/kg) 26 . Unfortunately, in the available literature, no data are present for penetration of ceftriaxone into ELF.…”

“…However, in comparison to ceftriaxone, another antimicrobial drug used frequently for treatment of CAP, ertapenem concentrations in lung tissue were much lower (7.60 ± 4.85 mg/kg vs 27.0 ± 9.00 mg/kg). 26 Unfortunately, in the available literature, no data are present for penetration of ceftriaxone into ELF. Like other βlactam antibiotics, the penetration of ertapenem into alveolar cells was poor.…”

Prevention of Surgical Site Infection: Beyond SCIP

“…13,14 Because of this, lower concentrations of antibiotic in the blood and other tissues occur. 15,16 Surgery for patients who are obese also is technically challenging and creation of dead space (ie, an actual or potential cavity remaining after the closure of an incision that is not obliterated by operative technique) regularly occurs. Finally, typical doses of antimicrobial prophylaxis are not adequate to "fill up the tank" in patients who are obese because the volume of distribution is larger.…”