PERIOPERATIVE ANTIBIOTIC-PROPHYLAXIS WITH CEFUROXIME IN ORAL MAXILLOFACIAL SURGICAL-PROCEDURES

A study was carried out to investigate the suitability of cefuroxime f or perioperative antibiotic prophylaxis in maxillofacial surgical proc edures. Serum and tissue samples were taken, to determine the intraope rative cefuroxime concentration, from 40 patients who had been given 1 .5 g cefuroxime (Zinacef(R)) i.v. during maxillofacial surgery. The ti me between i.v. administration and taking the blood and tissue samples varied between 10 and 260 min. The serum tissue kinetics were determi ned using an HPLC method in the jaw area, particular emphasis being gi ven to the concentrations measured in bone. It was demonstrated that c oncentrations of cefuroxime were reached which are above the MIC value s for many of the pathogens in the maxillofacial area and therefore ad equate protection during intraoperative bacterial contamination is gua ranteed. Maximum serum levels averaging 80 mg/l were measured within 3 0 min of administration. An average of 15 mg/l could still be demonstr ated after 4h. The bone samples gave maximum levels of 8-9 mg/kg 90 mi n after administration. Average levels of 1-3 mg/kg were still measura ble after 4 h. It is only possible to describe trends due to the wide variation in the values, particularly of the bone samples. No postoper ative wound infection was seen under prophylaxis with cefuroxime. Cefu roxime is suitable for perioperative prophylaxis during maxillofacial surgical procedures because of its favourable kinetics and broad spect rum of action.