title: [Plasma and tissue concentrations of cefamandole during cardiac surgery].
abstract: This study aimed to determine plasma (CPC) and tissue concentrations of cefamandole during cardiac surgery, so as to compare them with the minimal inhibitory concentration (MIC) for staphylococci (0.25 - 1 microgram.ml-1 for S. aureus; 2 micrograms.ml-1 for S. epidermidis). Cefamandole was given prophylactically to 8 consecutive patients as a single intravenous dose of 60 mg.kg-1. Tissue concentrations were measured in presternal subcutaneous loose tissue and sternal marrow. Average CPC was 233.75 +/- 58 micrograms.ml-1, 15 min after drug administration, 187 +/- 6.4 micrograms.ml-1 at the time of sternotomy, 57.9 +/- 36.5 micrograms.ml-1 10 min after the start of bypass and 36.4 +/- 18.4 micrograms.ml-1 at its end, and 15.5 +/- 5.9 micrograms.ml-1 at the end of the procedure. Sternal subcutaneous tissue and marrow concentrations were respectively 24.4 +/- 13.3 micrograms.g-1 and 31 +/- 5.6 micrograms.g-1 at the time of sternotomy, and 9.4 +/- 5.5 micrograms.g-1 and 9.2 +/- 3.5 micrograms.g-1 at the end of the procedure. Giving a high dose of cefamandole preoperatively appeared to have an effective prophylactic antibiotic action, as the plasma and tissue concentrations were always higher than the MIC for staphylococci.
authors.affiliation: Département d'Anesthésie-Réanimation, CHR de Brabois, Vandoeuvre-lès-Nancy.
authors.forename: M
authors.initials: M
authors.lastname: Clavey
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: T
authors.initials: T
authors.lastname: Hubert
authors.forename: B
authors.initials: B
authors.lastname: Delanoë
authors.forename: C
authors.initials: C
authors.lastname: Poussot
authors.forename: E
authors.initials: E
authors.lastname: Hottier
authors.forename: J P
authors.initials: JP
authors.lastname: Villemot
mesh_terms: D000368:Aged; D001853:Bone Marrow / Q000378:metabolism; D006348:Cardiac Surgical Procedures; D002435:Cefamandole / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics*; D003238:Connective Tissue / Q000378:metabolism; D005112:Extracorporeal Circulation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication; D013249:Sternum; D014018:Tissue Distribution
chemical_list: D002435:Cefamandole
vernacular_title: Concentrations sériques et tissulaires du céfamandole pendant la chirurgie cardiaque.