PHARMACOKINETICS OF AMPICILLIN, SULBACTAM AND CEFOTIAM IN PATIENTS UNDERGOING ORTHOPEDIC-SURGERY

As perioperative prophylaxis for major orthopedic operations 81 patien ts were given the fixed combination of ampicillin (1 g)/sulbactam (0.5 g) or cefotiam (2 g) as short infusions, The three beta-lactams were rapidly distributed into the different tissues and their pharmacokinet ic profiles were found to be very similar It was noteworthy that ampic illin, sulbactam and cefotiam penetrated within minutes, not only into skin, fat and muscles, but also into bone, Thus 0.25 h after starting the infusion the following mean concentrations were measured in bone: 21.8 +/- 10.5 mg/kg ampicillin, 4.9 +/- 2.2 mg/kg sulbactam and 19.4 +/- 10.6 mg/kg cefotiam, For a period of at least 2 h the concentratio ns measured in serum and in the different tissues affected by the oper ation (skin, fat, muscle, bone) were above the MICs for pathogens whic h are involved in postoperative wound infections, On the basis of phar macokinetic data, ampicillin/sulbactam and cefotiam seem about equally suitable for perioperative prophylaxis in major orthopedic operations .