COMPARATIVE PHARMACOKINETICS OF CEFTRIAXONE AFTER PERIINCISIONAL AND INTRAVENOUS ADMINISTRATION IN PATIENTS UNDERGOING ABDOMINAL-SURGERY

The advantages of the preoperative periincisional infiltration (ppi) o f ceftriaxone in the prophylaxis of surgical wound infections over the preoperative intravenous injection (piv) has been demonstrated by com paring the pharmacokinetics of the two routes of antibiotic administra tion and the clinical results. The study was conducted in 36 patients undergoing abdominal surgery. Eighteen of them received a 2 g ceftriax one piv (group A) and the rest a similar dose by ppi (group B). The pe ak time, peak plasma concentration and the bioavailability for the ppi route were respectively 1.19 +/- 0.24 h, 96.9 +/- 3.8 mu g/ml and 0.6 8 +/- 0.07. After piv, a typical bioexponential decline of plasma ceft riaxone levels from 256.7 +/- 37.5 mu g/ml (0.5 h) to 15.7 +/- 7.5 mu g/ml (24 h) was observed. Tissue and wound fluid antibiotic levels of patients from group B (range: for tissues 95-1850 mu g/g, for fluid 62 -1342 mu g/ml) were much higher than for group A (range: for tissues 1 8-150 mu g/g, for fluid 35-160 mu g/ml). Adequate for chemoprophylaxis antibiotic plasma levels were measured in both patient groups 24 h po st operatively (group A: 15.7 +/- 7.5 mu g/ml, group B: 12.4 +/- 4.5 m u g/ml). No wound infections or other complications were noted in grou p B. In contrast, three cases of wound infections and one case of pneu monia were observed in group A. (C) 1997 Elsevier Science B.V.