title: Comparative intraoperative concentrations of two cephalosporins with activity against anaerobic bacteria.
abstract: We determined the intraoperative concentrations of cefmetazole and cefoxitin in serum and muscle from the wound of 30 patients who were undergoing cholecystectomies. The study employed an open-label design in which all patients randomly received cefoxitin sodium (30 mg/kg) or cefmetazole sodium (15 or 30 mg/kg) intravenously with the induction of anesthesia. Total serum and wound-muscle concentrations achieved with cefmetazole 30 mg/kg were significantly greater than those achieved with a similar dose of cefoxitin. Cefmetazole in a 15 mg/kg dose was comparable with cefoxitin 30 mg/kg in achieved concentrations. The elimination half-life for cefoxitin was much shorter than that for cefmetazole (41 min v. 64-68 min, respectively) and this relates to a shorter duration of action for the former. The choice of agent for surgical prophylaxis should incorporate factors relating to drug pharmacokinetic properties as well as microbiological factors.
authors.affiliation: University of Georgia College of Pharmacy, Augusta.
authors.forename: J T
authors.initials: JT
authors.lastname: DiPiro
authors.forename: J E
authors.initials: JE
authors.lastname: Connors
authors.forename: T A
authors.initials: TA
authors.lastname: Bowden
authors.forename: J A
authors.initials: JA
authors.lastname: Stanfield
authors.forename: B M
authors.initials: BM
authors.lastname: Lampert
authors.forename: J T
authors.initials: JT
authors.lastname: Stewart
mesh_terms: D000293:Adolescent; D000328:Adult; D001421:Bacteria, Anaerobic / Q000187:drug effects*; D015311:Cefmetazole / Q000097:blood / Q000493:pharmacokinetics*; D002440:Cefoxitin / Q000097:blood / Q000493:pharmacokinetics*; D006801:Humans; D007432:Intraoperative Period; D008875:Middle Aged; D009132:Muscles / Q000378:metabolism; D011897:Random Allocation; D013997:Time Factors
chemical_list: D015311:Cefmetazole; D002440:Cefoxitin