AIMS: The aim of this pharmacokinetic study was to describe and quantify population pharmacokinetics of three antibiotics, cefazolin, ampicillin, and ciprofloxacin, used as antibacterial prophylaxis during cardiovascular surgery with the use of extracorporeal circulation (ECC). METHODS: Adult patients undergoing cardiac surgery with ECC were enrolled to this prospective, pharmacokinetic study. An intravenous bolus of 2 g of ampicillin, 2 g of cefazolin or 400 mg of ciprofloxacin was administered 60-30 min before surgery. Blood samples were collected at 15, 30, 45, 60, 120 and 180 min after the administration and at the end of the surgery. Plasma concentrations of the antibiotics were measured using HPLC methods. Serum concentration-time profiles were analyzed using nonlinear mixed-effects modeling approach. RESULTS: A total of 54 patients were enrolled into the study, 20 with ampicillin, 25 cefazolin and 9 ciprofloxacin. For all antibiotics, population pharmacokinetic models have been successfully developed. CONCLUSION: We identified estimated glomerular filtration rate (eGFR) as the main factor determining the achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target in ampicillin or cefazolin and body weight in ciprofloxacin prophylaxis during cardiac surgery with ECC support.
- Klíčová slova
- ampicillin, cardiac surgery, cefazolin, ciprofloxacin, extracorporeal circulation, population pharmacokinetics,
- MeSH
- ampicilin MeSH
- antibakteriální látky terapeutické užití MeSH
- antibiotická profylaxe metody MeSH
- cefazolin * farmakokinetika terapeutické užití MeSH
- ciprofloxacin MeSH
- dospělí MeSH
- kardiochirurgické výkony * MeSH
- lidé MeSH
- mimotělní oběh MeSH
- prospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- ampicilin MeSH
- antibakteriální látky MeSH
- cefazolin * MeSH
- ciprofloxacin MeSH
PURPOSE: The presence of Propionibacterium acnes in a substantial component of resected disc specimens obtained from patients undergoing discectomy or microdiscectomy has led to the suggestion that this prominent human skin and oral commensal may exacerbate the pathology of degenerative disc disease. This hypothesis, therefore, raises the exciting possibility that antibiotics could play an important role in treating this debilitating condition. To date, however, little information about antibiotic penetration into the intervertebral disc is available. METHODS: Intervertebral disc tissue obtained from 54 microdiscectomy patients given prophylactic cefazolin (n = 25), clindamycin (n = 17) or vancomycin (n = 12) was assayed by high-performance liquid chromatography, with cefaclor as an internal standard, to determine the concentration of antibiotic penetrating into the disc tissue. RESULTS: Intervertebral disc tissues from patients receiving the positively charged antibiotic clindamycin contained a significantly greater percentage of the antibacterial dose than the tissue from patients receiving negatively charged cefazolin (P < 0.0001) and vancomycin, which has a slight positive charge (P < 0.0001). CONCLUSION: Positively charged antibiotics appear more appropriate for future studies investigating potential options for the treatment of low-virulence disc infections. These slides can be retrieved under Electronic Supplementary Material.
- Klíčová slova
- Biofilm, Cefazolin, Clindamycin, Cutibacterium acnes, Degenerative disc disease, Propionibacterium acnes, Surgical prophylaxis, Vancomycin,
- MeSH
- antibakteriální látky farmakokinetika terapeutické užití MeSH
- cefazolin farmakokinetika terapeutické užití MeSH
- degenerace meziobratlové ploténky chirurgie MeSH
- dospělí MeSH
- grampozitivní bakteriální infekce prevence a kontrola MeSH
- klindamycin farmakokinetika terapeutické užití MeSH
- lidé MeSH
- meziobratlová ploténka metabolismus MeSH
- Propionibacterium acnes * MeSH
- vankomycin farmakokinetika terapeutické užití MeSH
- výhřez meziobratlové ploténky chirurgie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antibakteriální látky MeSH
- cefazolin MeSH
- klindamycin MeSH
- vankomycin MeSH
OBJECTIVE: To characterize the pattern of surgical antimicrobial prophylaxis in the Czech Republic. METHOD: Cross sectional survey with a self-administered postal questionnaire. Data collected included use of antimicrobial prophylaxis, surgical site infection rate, pathogens causing surgical site infection and demographics of the institution. Descriptive and multivariate analyses were performed. SETTING: Hospital, surgical departments in the Czech Republic. MAIN OUTCOME MEASURE: Prevalence of surgical antimicrobial use, factors associated with use, the profile of antimicrobial use, timing, route, dosage regimen and duration of initiated prophylaxis. RESULT: The response rate was 55.5%. Surgical antimicrobial prophylaxis was used in 97.5% of departments, and 85% departments justified prophylaxis based on guideline. The timing of the first dosage was within 2 h of operation in 95.0% of departments and 36.7% of all departments administered more than 2 doses of SAP in operations that lasted less than 4 h of all respondents. The three most common prophylactic antimicrobial agent used were cefazolin, co-amoxiclav and cefuroxime amongst the 26 single antimicrobial agents and 16 antimicrobial combinations. Penicillins and enzyme inhibitor was the most frequent class used. Surgical antimicrobial prophylaxis was administered intravenously in 82.5% of all cases. The regimen used varied markedly in dose and duration prescribed. The surgical site infection rate occurred. 1-5% in 71.7% of departments. Most departments identified the causative pathogen at all times. Staphylococcus aureus was the most frequent pathogen of surgical site infection and was detected in 90.8% of all departments. There was significant association between Pseudomonas aeruginosa with cefuroxime use and Bacteriodes fragilis with co amoxiclav use. CONCLUSION: This survey has identified several areas for improvement in surgical antimicrobial prophylaxis in the Czech Republic. Particular areas of concern include route of administration, duration and timing of first dosage of SAP, and the inappropriate use of broad-spectrum antimicrobials.
- MeSH
- antibakteriální látky aplikace a dávkování terapeutické užití MeSH
- antibiotická profylaxe * MeSH
- cefazolin aplikace a dávkování terapeutické užití MeSH
- cefuroxim aplikace a dávkování terapeutické užití MeSH
- dodržování směrnic MeSH
- infekce chirurgické rány prevence a kontrola MeSH
- kombinace amoxicilinu a kyseliny klavulanové aplikace a dávkování terapeutické užití MeSH
- lidé MeSH
- nemocnice MeSH
- průzkumy zdravotní péče MeSH
- rozvrh dávkování léků MeSH
- směrnice pro lékařskou praxi jako téma MeSH
- spotřeba léčiv MeSH
- způsoby aplikace léků MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Názvy látek
- antibakteriální látky MeSH
- cefazolin MeSH
- cefuroxim MeSH
- kombinace amoxicilinu a kyseliny klavulanové MeSH
OBJECTIVE: To verify the significance of Cefazolin administration to women who were indicated for caesarean section. SETTING: Department of Obstetrics and Gynecology, First Faculty of Medicine, Prague, Czech republic. METHODS: Cefazolin was administered to 30 women with a patient history risk in a dose of 1 mg i.v. after ligation of the umbilical cord. The control group consisted of 30 women. Observed parameters: weight gain during pregnancy, indications for caesarean section, culture from the cervix and vagina prior to the caesarean section, culture from the amniotic fluid, culture from the 4th day lochia, temperature curve, leucocyte count before and 4 days after the operation, complications after the surgery, administration of antibiotics, and length of hospitalisation. RESULTS: In the group with antibiotic prophylaxis, we observed a more favourable course of the temperature curve and a smaller leucocyte count the fourth day after the surgery (p < 0.01), in comparison with the women without prophylaxis. The duration of hospitalisation in women with antibiotic prophylaxis was one day shorter and there was no occurrence of febrile complications requiring further antibiotic treatment. CONCLUSION: Cafazolin is advantageous antibiotic for prophylaxis in caesarean section in patients with risk.
- MeSH
- antibiotická profylaxe * MeSH
- cefalosporiny terapeutické užití MeSH
- cefazolin terapeutické užití MeSH
- císařský řez * škodlivé účinky MeSH
- lidé MeSH
- pooperační komplikace prevence a kontrola MeSH
- prospektivní studie MeSH
- puerperální infekce prevence a kontrola MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- klinické zkoušky kontrolované MeSH
- klinické zkoušky MeSH
- Názvy látek
- cefalosporiny MeSH
- cefazolin MeSH
- MeSH
- antibiotická profylaxe * MeSH
- cefalosporiny terapeutické užití MeSH
- cefazolin terapeutické užití MeSH
- gynekologické chirurgické výkony * MeSH
- lidé MeSH
- pooperační komplikace prevence a kontrola MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cefalosporiny MeSH
- cefazolin MeSH
Determinants of resistance of imipenem can be, in Pseudomonas aeruginosa strains resistant to this drug, transferred by transduction with wild-type phages as well as mobilized for conjugal transfer, as demonstrated by the indirect selection procedure. Exconjugants obtained in the latter type of experiments do not transfer imipenem resistance determinant to further recipient strains(s) by conjugation. Mobilized imipenem resistance is of non-hydrolytic character and its biochemical mechanism is unknown at present.
- MeSH
- antibiotická rezistence genetika MeSH
- cefazolin farmakologie MeSH
- cefotaxim farmakologie MeSH
- fenotyp MeSH
- imipenem farmakologie MeSH
- konjugace genetická genetika MeSH
- Pseudomonas aeruginosa účinky léků genetika fyziologie MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cefazolin MeSH
- cefotaxim MeSH
- imipenem MeSH
The authors compare the effectiveness of three types of antibiotic prophylaxis (1. cephazoline, 2. combination ampicillin + oxacillin, 3. clindamycin) in a group of 32 patients with resection of oropharyngeal carcinomas and in a group of 47 laryngectomies with cervical block resection. The criterium is the incidence of postoperative infections, which called for a change of antibiotic treatment. The authors evaluates favourably prophylaxis with cephazoline and clindamycin; the incidence of complications is within the range of 17-30%. In ampicillin + oxacillin therapy unsatisfactory results with a 46% incidence of inflammatory complications were recorded. A gram-negative flora causes 45% infectious complications; the author also draws attention to the danger of anaerobic infections. In a primarily contaminated oropharyngeal area there is an incidence of postoperative infections by 30% higher in all types of evaluated prophylaxis, as compared with the laryngocervical area.
- MeSH
- ampicilin terapeutické užití MeSH
- antibakteriální látky terapeutické užití MeSH
- bakteriální infekce farmakoterapie MeSH
- cefazolin terapeutické užití MeSH
- klindamycin terapeutické užití MeSH
- lidé MeSH
- otorinolaryngologické nemoci chirurgie MeSH
- oxacilin terapeutické užití MeSH
- pooperační komplikace farmakoterapie MeSH
- premedikace * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- ampicilin MeSH
- antibakteriální látky MeSH
- cefazolin MeSH
- klindamycin MeSH
- oxacilin MeSH
A comparison was made of the use of thienamycin and cefazolin in antimicrobial prophylaxis of patients undergoing major thoracic noncardiac surgery. Fever and failure or success of prophylaxis were used as criteria. Both cefazolin and thienamycin were of the same value in cases of lung resections, while thienamycin was clearly superior in resections of thoracic oesophagus.
- MeSH
- bakteriální infekce prevence a kontrola MeSH
- cefazolin terapeutické užití MeSH
- ezofágus chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- náhodné rozdělení MeSH
- plíce chirurgie MeSH
- pooperační komplikace prevence a kontrola MeSH
- premedikace * MeSH
- thienamyciny terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky kontrolované MeSH
- klinické zkoušky MeSH
- srovnávací studie MeSH
- Názvy látek
- cefazolin MeSH
- thienamycin MeSH Prohlížeč
- thienamyciny MeSH
- MeSH
- cefazolin aplikace a dávkování MeSH
- císařský řez * MeSH
- lidé MeSH
- premedikace * MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- cefazolin MeSH
- MeSH
- cefazolin metabolismus MeSH
- dospělí MeSH
- kinetika MeSH
- lidé MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- cefazolin MeSH
