Summary
We compared the prophylactic use of cefamandole and ceftriaxone in 40 patients undergoing elective cardiac surgery. Postoperative wound infection occurred in one and two patients, respectively, in each group (n. s.), and bronchial superinfection in one patient in each group. In 12 additional patients drug concentrations in plasma and pericardial fluid were measured at different times following the administration of ceftriaxone. Plasma and pericardial fluid concentrations of ceftriaxone were above the minimal inhibitory concentration of susceptible microorganisms for up to 24 h after intravenous administration. We conclude, firstly, that the incidence of infection after cardiac surgery is low with both cefamandole and ceftriaxone prophylaxis. Secondly, efficient plasma and pericardial fluid levels of ceftriaxone last for up to 24 h after intravenous administration.
Zusammenfassung
In einer prospektiven, randomisierten Studie verglichen wir bei 40 herzchirurgischen Patienten Cefamandol und Ceftriaxon als Infektionsprophylaxe. Bei weiteren 12 Patienten wurden Plasma- und perikardiale Flüssigkeitsspiegel von Cefamandol in verschiedenen Zeitabständen nach dessen Verabreichung bestimmt. Eine postoperative Wundinfektion wurde bei einem, respektive zwei Patienten in jeder Gruppe (Cefamandol-Ceftriaxon) beobachtet, und eine bronchiale Superinfektion bei je einem Patienten. Die Plasma- und perikardialen Flüssigkeitsspiegel für Ceftriaxon waren weit über der minimalen inhibitorischen Konzentration für alle auf Ceftriaxon ansprechende Erreger, selbst 24 h nach intravenöser Verabreichung. Wir ziehen die Schlußfolgerung, daß erstens die Infektionsrate nach herzchirurgischen Eingriffen sowohl mit Cefamandolals auch mit Ceftriaxon-Prophylaxe sehr gering ist und zweitens auch 24 h nach Ceftriaxon-Verabreichung noch bakterizide Konzentrationen im Plasma und in der perikardialen Flüssigkeit vorliegen.
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Neidhart, P., Gunning, K., Suter, P.M. et al. A comparative study of cefamandole and ceftriaxone as prophylaxis in cardiac surgery. Infection 18, 101–104 (1990). https://doi.org/10.1007/BF01641425
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DOI: https://doi.org/10.1007/BF01641425