TOBIN CM, GRAY J, ADRIANZEN M, BRAWN WJ, ZHANG J, WHITE LO, MACGOWAN AP; Interscience Conference on Antimicrobial Agents and Chemotherapy (41st : 2001 : Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2001 Dec 16-19; 41: abstract no. G-1521.
BCARE, Bristol, United Kingdom
BACKGROUND: Studies have demonstrated that during CPB surgery antibiotics given as prophylaxis decrease sharply and may lead to sub-therapeutic concentrations. No studies have been performed to investigate AMX and FLX concentrations in infants undergoing CPB surgery. METHODS: 11 infants (<5 kg) undergoing CPB surgery for correction of congenital heart defects were recruited. A single dose of AMX (30 mg/kg) and FLX (30 mg/kg) was administered. Serum and paired rectus abdominus muscle samples were collected prior to CPB (A), during CPB (before aorta cross-clamping; (B)), after CPB (C) and at the end of surgery (D). Antibiotic concentrations were determined by high performance liquid chromatography. RESULTS: The mean AMX concentrations +/- standard deviation (SD) and (ranges) were for serum: A 67.9 +/- 42.0 mg/L (0.0 - 134.7 mg/L); B 38.7 +/- 28.3 mg/L (1.6 - 90.7 mg/L); C 37.2 +/- 28.2 mg/L (1.3 - 88.2 mg/L); D 34.7 +/- 28.8 mg/L (0.0 -86.8 mg/L) and for tissue: A 27.0 +/- 24.2 mg/L (0.0 - 75.9 mg/L); B 27.5 +/- 23.0 mg/L (0.0 - 69.9 mg/L); C 21.8 +/- 18.7 mg/L (0.0 - 57.5 mg/L); D 22.2 +/- 19.4 mg/L (0.0 - 62.5 mg/L). & +/- FLX concentrations mean +/- SD and (ranges) were for serum: A 88.2 +/- 33.5 mg/L (33.1 - 140.7 mg/L); B 45.1 +/- 19.4 mg/L (14.4 - 82.9 mg/L); C 44.6 +/- 22.3 mg/L (15.2 - 80.3 mg/L); D 44.4 +/- 24.8 mg/L (13.9 - 80.9 mg/L) and for tissue: A 14.8 +/- 13.6 mg/L (0.0 - 51.6 mg/L); B 15.2 +/- 17.9 mg/L (0.0 - 60.4 mg/L); C +/- 8.8 mg/L (0.0 - 35.6 mg/L); D 9.9 +/- 12.2 mg/L (0.0 - 37.6 mg/L). CONCLUSIONS: Despite a 50% reduction in AMX and FLX serum levels post CPB the concentrations were therapeutic. Antibiotic tissue concentrations were variable but this may be attributed to many of the samples being of a low weight. However, for the majority patients, the tissue concentrations were adequate also.
Publication Types:
Keywords:
- Amoxicillin
- Anti-Bacterial Agents
- Cardiac Surgical Procedures
- Cardiopulmonary Bypass
- Coronary Artery Bypass
- Floxacillin
- Heart Defects, Congenital
- Hemofiltration
- Humans
- Infant
- Intraoperative Period
- surgery
Other ID:
UI: 102270131
From Meeting Abstracts