Plasma and Tissue Concentrations of Ceforanide and Cefazolin in Women Undergoing Hysterectomy

Abstract

Thirty-four women who underwent vaginal hysterectomy received either ceforanide or cefazolin as perioperative antimicrobial prophylaxis. Samples of plasma, myometrium, endometrium and fallopian tubes were obtained at various intervals after injection and were assayed for cephalosporin concentration. Following intramuscular injection approximately 1 h prior to surgery, both drugs provided adequate tissue levels at the time of the procedure. Although both antimicrobials achieved similar tissue concentrations, all tissue samples for ceforanide exceeded the MIC₉₀ for Escherichia coli while in the cefazolin group 9/18 myometrial samples and 10/15 endometrial samples fell below the MIC₉₀ for this organism.

Effect of High-Volume Therapy on Cefazolin Serum Concentrations in Multiple-Trauma Patients

“…The results of this study may be limited because of lacking tissue and bone concentrations but several studies could demonstrate a direct dependency between serum concentrations and tissue or bone concentrations [6,9,11,13,25,27]. With regard to these studies and to avoid local complications (i. e. bleeding, infection), we waived to measure tissue and bone concentrations.…”

“…Therefore, an additional dose of cefazolin was recommended, if operation time exceeds 3 or 4 hours [1,16,21,25,26]. Patients with multiple trauma have often associated open or closed fractures and extended injuries to the soft tissue.…”