PENETRATION OF AMPICILLIN AND SULBACTAM INTO HUMAN EPIDIDYMIS AND TESTIS

Urologic refertilization microsurgery such as vaso-vasostomy or vaso-e pididymostomy benefits from perioperative antibiotic prophylaxis, The ability of ampicillin and sulbactam to penetrate sufficiently into mix ed epididymis or testis tissue was investigated in nine patients (body weights ranged from 58 kg to 92 kg, mean 77.3 kg) undergoing orchiecto my for testicular cancer or advanced prostatic cancer, Each patient re ceived a single infusion of 3 g ampicillin/sulbactam (ratio 2:1) preop eratively for antibiotic prophylaxis, The concentrations of both compo nents were determined in serum and in epididymis/testis tissue samples taken 30 min to 65 min after infusion, Ampicillin was determined by b ioassay and sulbactam was determined by gas chromatography/mass spectr ometry, Mean tissue concentrations of ampicillin were 38.5 +/- 15.9 mg /kg, Mean tissue concentrations of sulbactam at the same time were 19. 8 +/- 5.2 mg/kg. Comparison of the tissue/serum ratios for both agents showed no significant difference, These values indicate that both com pounds achieve high concentrations in the scrotal organs, The concentr ations exceed the MIC (minimal inhibitory concentration) values of imp ortant bacterial pathogens such as Staphylococcus aureus involved in p ostoperative wound infections, The combination of ampicillin and sulba ctam may be effective for perioperative prophylaxis in reconstructive scrotal urologic surgery.