CONCENTRATIONS OF CEFTRIAXONE IN ABDOMINA L TISSUES AFTER USE FOR ANTIBIOTIC-PROPHYLAXIS (1,000 MG IV) DURING PANCREATIC SURGERY

Ceftriaxone concentration in abdominal tissues (abdominal wall fat, ep iploic fat, pancreatic tissue, pancreatic fluid, pancreatic bile and l iver) was evaluated after administration as antibiotic prophylaxis for pancreatic surgery, Ceftriaxone concentrations in fatty tissues range d from 2.5 +/- 1.3 to 6.2 +/- 2.9 mu g/ml. Ceftriaxone concentrations reached 6.0 +/- 8.6 mu g/g in pancreatic tissues, 2.1 +/- 2.5 mu g/ml in pancreatic fluid, 1179 +/- 1271 mu g/ml in pancreatic bile, and 18 +/- 16 mu g/g in the liver. In fatty tissues 8 out of 10 patients had levels above the MIC90 for Staphylococcus aureus and Escherichia coli and all 10 patients had levels above the MIC90 for Klebsiella pneumoni ae and Proteus mirabilis. In other tissues, penetration was greater th an the MIC90 for potential pathogens in 50 to 100% of patients, In con clusion, high ceftriaxone concentrations in the studied tissues were o bserved in most patients during pancreatic surgery. For antibiotic pro phylaxis in pancreatic surgery, a single dose of 1,000 mg can be consi dered for most patients, An additional dose of 1,000 mg can be conside red for longer procedures (beyond 4 hours).