Population pharmacokinetic evaluation of cefuroxime in perioperative antibiotic prophylaxis during and after cardiopulmonary bypass

Rimmler, Christer; Lanckohr, Christian; Mittrup, Miriam; Welp, Henryk; Würthwein, Gudrun; Horn, Dagmar; Fobker, Manfred; Ellger, Björn; Hempel, Georg

doi:10.1111/bcp.14556

Cited by 4 publications

(2 citation statements)

References 34 publications

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“…Studies found that despite cefuroxime target-attainment drug levels being reached after their perioperative administration, such levels could not be maintained in the immediate postoperative period, which could explain why it was insufficient as a monotherapy strategy [28]. In comparison, ceftriaxone levels seem to be higher but not enough to completely protect against Pseudomonas in monotherapy [29].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Three Antibiotic Prophylaxis Protocols for Preventing Postoperative Infection in Tibial Plateau Fractures

Montoya-delaTorre,

Muñoz-Mahamud,

Zumbado

et al. 2024

Applied Sciences

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Background: The aim of this study was to compare the impact of three different types of intraoperative antibiotic prophylaxis on the risk of postoperative surgical site infection (SSI). Material and Methods: Single-center retrospective cohort study. Patients who underwent surgery for osteosynthesis of a tibial plateau fracture (January 2009–November 2018) in Hospital Clinic i Provincial de Barcelona were included. Three types of prophylaxis during the study period were used: group A (cefuroxime single-dose treatment), group B (meropenem + teicoplanin), and group C (ceftriaxone + teicoplanin). Demographics, co-morbidity, type of fracture, need for external fixation, microbiology data, surgical time, and outcome were recorded. Failure was defined as the need for reintervention due to postoperative surgical site infection. Results: From a total of 148 patients included, 20 cases developed SSI, 8 from group A, 8 from group B, and 4 from group C. Higher ASA scores, Schatzker II classification, need for external fixation, and a prolonged surgical time were associated with a significantly (p < 0.005) increased incidence of SSI. Group C showed the overall highest survival and lowest cumulative risk, but differences were not statistically significant. Conclusions: Group C showed the lowest incidence of infection in this sample. It is necessary to confirm these findings with larger studies.

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Section: Discussionmentioning

confidence: 99%

Comparison of Three Antibiotic Prophylaxis Protocols for Preventing Postoperative Infection in Tibial Plateau Fractures

Montoya-delaTorre,

Muñoz-Mahamud,

Zumbado

et al. 2024

Applied Sciences

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“…The recommended proposal is similar to the American Clinical Practice Guidelines for Antimicrobial Prophylaxis in Surgery [28] . Christer Rimmler [29] reported that dosing recommendations for CXM as perioperative AP in cardiac surgery are su cient to reach plasma unbound concentration to cover S. aureus during the operation. However, J Lanoiselée et al [30] stated common dosing regimens of 1.5 g CXM recommended by US and European guidelines did not sustain therapeutic concentrations throughout cardiac surgery and proposed an optimized dosing regimen according to the population analysis of CXM pharmacokinetics.…”

Section: Discussionmentioning

confidence: 99%

Whether 3.0 g cefuroxime prophylaxis before cardiac surgery diminished postoperative pneumonia and persistent fever compared with 1.5 g: a nested case-control study

Yang,

Ge,

Min

et al. 2024

Preprint

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Objectives Whether 3.0 g CXM prophylaxis before cardiac surgery can effectively avoid POP and persistent POFcompared with 1.5 g is debatable, which needs to be confirmed by evidence medical research. Methods A total of 301 patients who underwent CXM prophylaxis before cardiac surgery from Jan 2023 to Dec 2023 at the First Affiliated Hospital of Nanjing Medical University were incorporated in a nested case-control study. The patients were divided into the 1.5 g (n=170) and 3.0 g (n=131) groups according to the dosage of prophylactic CXM. Outcomes included POP and persistent POF. Risk andstratification analysis was performed for the effect andmodification of different doses of CXM on outcomes. Results The incidence of persistent POF in 1.5 g group (52, 30.59%) was lower than that in 3.0 g group (67, 51.15%) unadjusted (OR=2.38, 95%CI:1.48~3.81, P<0.001) or adjusted (OR=2.38, 95%CI:1.36~4.14, P=0.002) for the confounding variables. There was no significant difference in POP between the two groups unadjusted (OR=1.26, 95%CI:0.62~2.55, P=0.522) or adjusted (OR=1.03., 95%CI:0.48~2.20, P=0.945) for the confounding variables. The results of stratification analysis defined that two different dosages of prophylactic CXM didn’t generate effect modification on the risk factors of persistent POF. Conclusions 3.0 g CXM prophylaxis before cardiac surgery didn’t decrease the incidence of POP but increased the risk of persistent POF compared with 1.5 g. Given the facts, this study may point the solution of CXM preoperative prophylaxis for cardiac surgery.

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Anterior medial minimally invasive plate osteosynthesis for humeral shaft fractures shows superior early shoulder and elbow function compared to locking compression plate: A retrospective study

Yang,

Ouyang,

Yang

et al. 2024

Injury

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Population pharmacokinetic evaluation of cefuroxime in perioperative antibiotic prophylaxis during and after cardiopulmonary bypass

Abstract: CR, CL, DH, BE, GW and GH conceived the study. CL, MM and HW recruited patients and collected clinical specimens. MF performed HPLC analyses. All authors contributed to data analysis and writing of the manuscript.

Cited by 4 publications

References 34 publications

Comparison of Three Antibiotic Prophylaxis Protocols for Preventing Postoperative Infection in Tibial Plateau Fractures

Comparison of Three Antibiotic Prophylaxis Protocols for Preventing Postoperative Infection in Tibial Plateau Fractures

Whether 3.0 g cefuroxime prophylaxis before cardiac surgery diminished postoperative pneumonia and persistent fever compared with 1.5 g: a nested case-control study

Anterior medial minimally invasive plate osteosynthesis for humeral shaft fractures shows superior early shoulder and elbow function compared to locking compression plate: A retrospective study

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