Pharmacokinetics of antibiotic prophylaxis in major orthopedic surgery and blood-saving techniques

• Published in: Orthopedics (Thorofare, N.J.) Vol. 24; no. 7; pp. 665 - 669
• Main Authors: DEHNE, Marius G, MÜHLING, Jörg, SABLOTZKI, Armin, NOPENS, Heike, HEMPELMANN, Gunter
• Format: Journal Article
• Language: English
• Published: Thorofare, NJ Slack 01.07.2001; SLACK INCORPORATED
• Subjects: Aged; Ampicillin - economics; Ampicillin - metabolism; Ampicillin - pharmacokinetics; Antibacterial agents; Antibiotic Prophylaxis - economics; Antibiotic Prophylaxis - methods; Antibiotic Prophylaxis - standards; Antibiotics. Antiinfectious agents. Antiparasitic agents; Biological and medical sciences; Blood Transfusion, Autologous - adverse effects; Bone and Bones - chemistry; Cefamandole - economics; Cefamandole - metabolism; Cefamandole - pharmacokinetics; Cefotiam - economics; Cefotiam - metabolism; Cefotiam - pharmacokinetics; Cefuroxime - economics; Cefuroxime - metabolism; Cefuroxime - pharmacokinetics; Cephalosporins - economics; Cephalosporins - metabolism; Cephalosporins - pharmacokinetics; Drug Monitoring; Drug Therapy, Combination - economics; Drug Therapy, Combination - metabolism; Drug Therapy, Combination - pharmacokinetics; Female; Fluid Therapy - methods; Humans; Male; Medical sciences; Metabolic Clearance Rate; Middle Aged; Orthopedic Procedures - adverse effects; Pharmacology. Drug treatments; Risk Factors; Sulbactam - economics; Sulbactam - metabolism; Sulbactam - pharmacokinetics; Time Factors; Tissue Distribution; Human; Transfusion; Enzyme; Treatment efficiency; β-Lactams; Cefotiam; Enzyme inhibitor; β-Lactamase; Prevention; Cefuroxime; Antibiotic; Chemotherapy; Cephalosporin derivatives; Orthopedic surgery; Cefamandole; Ampicillin; Blood salvage; Blood loss; Hydrolases; Combined treatment; Technique; Antibacterial agent; Pharmacokinetics; Sulbactam
• ISSN: 0147-7447; 1938-2367
• DOI: 10.3928/0147-7447-20010701-15

The pharmacokinetics of cefuroxime, cefotiam, cefamandole, and ampicillin/sulbactam were randomly measured in 40 patients undergoing major orthopedic surgery associated with high blood and volume turnover and intraoperative blood salvage. Serum and bone concentrations and the pharmacokinetics occurring in the context of these procedures were measured. No changes in elimination half-life relative to a normal population occurred with cefuroxime, cefotiam, and ampicillin. Serum and tissue concentrations were slightly lower with cefamandole and sulbactam, but reapplication of the initial dose was required with all antibiotics 4 hours after the first application.