Blood concentrations of cefuroxime in cardiopulmonary bypass surgery

Autor: Peter G. J. ter Horst, Wobbe Hospes, Alexander J. Spanjersberg, Bob Wilffert, Daphne Bertholee, Michel L. Hijmering
Přispěvatelé: Methods in Medicines evaluation & Outcomes research (M2O), Reproductive Origins of Adult Health and Disease (ROAHD)
Jazyk: angličtina
Rok vydání: 2013
Předmět:
Male
PHARMACOKINETICS
ADVISORY STATEMENT
Pharmaceutical Science
Pilot Projects
Pharmacy
Toxicology
law.invention
law
Hypothermia
Induced
Medicine
Pharmacology (medical)
Antibiotic prophylaxis
Coronary Artery Bypass
Netherlands
Cardiopulmonary bypass
MICRODIALYSIS
Middle Aged
Cardiac surgery
Anti-Bacterial Agents
Catheter
medicine.anatomical_structure
surgical procedures
operative
Anesthesia
Injections
Intravenous
Female
ANTIBIOTICS
Artery
medicine.drug
Glomerular Filtration Rate
Risk
medicine.medical_specialty
PLASMA-CONCENTRATIONS
CONTINUOUS-INFUSION
Renal function
Coronary artery bypass graft surgery
INFECTION PREVENTION PROJECT
medicine.artery
Humans
Surgical Wound Infection
Radial artery
Hospitals
Teaching
Perioperative Period
Aged
Pharmacology
Cefuroxime
business.industry
ANTIMICROBIAL PROPHYLAXIS
Surgery
TISSUE
Feasibility Studies
business
CARDIAC-SURGERY
Zdroj: International Journal of Clinical Pharmacy, 35(5), 798-804. SPRINGER
ISSN: 2210-7703
Popis: Objectives Patients with coronary artery bypass graft (CABG) surgery are at risk for severe postoperative infections. Prophylactic cefuroxime may help to reduce this risk, however sufficient concentrations, i.e. above the breakpoint (32 mg/L), are mandatory. The aim of this study is to evaluate the blood concentrations of cefuroxime during and after CABG surgery with cardiopulmonary bypass (CPB) and hypothermia, to determine the concentration of cefuroxime in sternum fluid and to evaluate possible factors of influence. Methods Seventeen patients were enrolled in this study, given 1.5 g cefuroxime at anaesthesia induction and an additional 1.5 g at start CPB. Blood samples were collected at skin incision, start CPB, every 30 min on CPB, end CPB, at wound closure and 1 h after surgery. Cefuroxime concentrations were determined by high performance liquid chromatography. Results In 47 % of the patients the cefuroxime concentration was below the breakpoint at some point during the operation and in 59 % of the patients 1 h after surgery. A statistically significant inverse correlation between estimated glomerular filtration rate and plasma cefuroxime concentrations was found (P = 0.034). Cefuroxime levels in the sternum are not significantly different from blood levels from the radial artery catheter, taken at approximately the same time (P = 0.30). Conclusions The current antibiotic regimen used did not maintain cefuroxime concentrations above the breakpoint throughout the operation, suggesting insufficient antibiotic prophylaxis. Further research to other antibiotic regimes is therefore necessary.
Databáze: OpenAIRE
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