title: Pharmacokinetics and tissue penetration of a single 1,000-milligram, intravenous dose of metronidazole for antibiotic prophylaxis of colorectal surgery.
abstract: The levels of metronidazole in serum and tissue penetration of metronidazole were studied after prophylactic administration in 11 patients undergoing elective colorectal surgery. A single dose of 1,000 mg given intravenously was administered before surgery. Adequate drug levels in serum (greater than or equal to MIC for 90% of strains tested [MIC90] for Bacteroides fragilis) were found in all patients throughout the procedure. Mean peak (15-min) and last-determined (24-h) metronidazole levels in serum were 28.8 +/- 8 and 4.2 +/- 1.7 mg/liter, respectively. The beta-phase elimination half-life was 9.5 +/- 2.3 h, and the clearance and apparent volume of distribution were 57 +/- 13 ml/min and 0.7 +/- 0.1 liter/kg, respectively. In the colonic wall at surgical anastomosis, tissue metronidazole levels greater than or equal to MIC90 for B. fragilis were found in 91% of patients. In the abdominal wall fat and epiploic fat, tissue metronidazole levels greater than or equal to MIC90 for B. fragilis were found in 40 to 60% of patients at surgical incision and closure. No anaerobic infection occurred during the study.
authors.affiliation: Department of Anesthesia and Intensive Care, Sainte Marguerite Hospital, Marseille, France.
authors.forename: C
authors.initials: C
authors.lastname: Martin
authors.forename: B
authors.initials: B
authors.lastname: Sastre
authors.forename: M N
authors.initials: MN
authors.lastname: Mallet
authors.forename: B
authors.initials: B
authors.lastname: Bruguerolle
authors.forename: J P
authors.initials: JP
authors.lastname: Brun
authors.forename: P
authors.initials: P
authors.lastname: De Micco
authors.forename: F
authors.initials: F
authors.lastname: Gouin
mesh_terms: D000368:Aged; D001441:Bacteroides fragilis / Q000187:drug effects; D003106:Colon / Q000601:surgery*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007432:Intraoperative Period; D008297:Male; D008795:Metronidazole / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008875:Middle Aged; D011292:Premedication; D012007:Rectum / Q000601:surgery*; D014018:Tissue Distribution
chemical_list: D008795:Metronidazole