INTRAVENOUS CEFUROXIME PROPHYLAXIS - TISSUE-LEVELS AFTER ONE 3-GRAM DOSE IN 40 CASES OF HIP FRACTURE

This study consists of 2 series of patients with cervical hip fracture treated with hemiarthroplasty. In a preliminary study, the method, ti ming of sample collection, and tissue and serum concentrations were st udied in 15 patients. In the main study of another 25 patients, only t issue samples were collected. In the preliminary study, 3 g of cefurox ime was infused in 15-25 min and serum, muscle, fascia and bone sample s were collected at Various times. In the main study, 7 dose of 3 g of cefuroxime was infused in 15 min. Skin, muscle, fascia, and bone tiss ue samples were collected after 30 and 45 min and the concentrations o f cefuroxime were measured by high-performance liquid chromatography. In the preliminary study, serum cefuroxime levels were 61 mu g/mL and 42 mu g/mL at 15-30 and 35-50 min, respectively. Cefuroxime levels in various tissues were only slightly less than those in serum. Blood con tamination contributed less than 30 percent to the tissue levels of ce furoxime. In the main study, mean cefuroxime levels in the tissues wer e in the range of 39-58 mu g/g, and the total range was 5.5-151 mu g/g at 30 and 45 min. These concentrations are well above the MIC values of the most common bacteria causing wound and bone infections.