PREINCISIONAL SINGLE-DOSE CEFTRIAXONE FOR THE PROPHYLAXIS OF SURGICAL-WOUND INFECTION

BACKGROUND: Preincisional intraparietal injection of antibiotics is us ed for the prophylaxis of postoperative surgical infections, Whether t opically injected antibiotics remain primarily in the surgical wound o r are systematically absorbed is uncertain, however. PATIENTS AND METH ODS: The pharmacokinetics of preincisional injection of 2 g ceftriaxon e were studied in 20 patients who have undergone abdominal surgery, wi th determination of serum, wound tissue, and wound fluid antibiotic co ncentrations. RESULTS: Preincisional injection of ceftriaxone resulted in high antibiotic concentrations in the wound tissue and wound fluid . The highest plasma concentrations were achieved at 1.50 hours (99.47 +/- 14.67 mu g/mL). Plasma concentrations exceeded the minimal inhibi tory concentrations of most aerobic gram-positive and gramnegative org anisms with the exception of Pseudomonas aeruginosa, Acinetobacter spe cies, and Streptococcus faecalis for 24 hours (10.42 +/- 4.12), No loc al or general complications arose in any of the patients. CONCLUSIONS: Our results suggest that preincisional administration of ceftriaxone for prophylaxis is very effective.