title: Concentrations of fusidic acid, cloxacillin, and cefamandole in sera and atrial appendages of patients undergoing cardiac surgery.
abstract: The concentrations of cefamandole, cloxacillin and fusicid acid were measured in the serum and heart tissue of 100 recipients of these drugs before cardiac surgery. During cardiopulmonary bypass, mean (+/- standard deviation) peak concentrations in serum of all patients were 63.0 +/- 34.0 micrograms of cefamandole per ml, 30.8 +/- 17.7 micrograms of cloxacillin per ml, and 32.4 +/- 10.8 micrograms of fusidic acid per ml. Mean (+/- standard deviation) concentrations in atrial appendages taken 1 h (+/- 15 min) after infusion were 21.3 +/- 11.0 micrograms of cefamandole per g, 23.8 +/- 17.3 micrograms of cloxacillin per g, and 10.7 +/- 4.2 micrograms of fusidic acid per g. No cloxacillin could be detected in 5 of 39 heart specimens. Mean tissue-to-serum ratios at 1 h for cefamandole, cloxacillin, and fusidic acid were respectively 0.35, 0.73, and 0.33. Fusidic acid, a drug which is highly effective in vitro against both methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis, was detectable in heart tissue in concentrations which were 12 times higher than the MICs of this agent against these resistant microorganisms.
mesh_terms: D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002435:Cefamandole / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use; D003023:Cloxacillin / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use; D005260:Female; D005672:Fusidic Acid / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use; D006207:Half-Life; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011292:Premedication
chemical_list: D005672:Fusidic Acid; D002435:Cefamandole; D003023:Cloxacillin