title: Plasma levels of ceftriaxone in cardiovascular surgery.
abstract: In 512 patients undergoing major cardiovascular surgery, this prospective, randomized study compared the effectiveness of perioperative prophylaxis with either ceftriaxone or cefuroxime. In the ceftriaxone group, 254 patients received a single 2 g dose given intravenously at the start of anesthesia followed by a 1 g dose 24 hours later. In the cefuroxime group, 258 patients received 1.5 g at the start of anesthesia, followed by 1.5 g given intravenously every 12 hours for 2 days postoperatively. Postoperative infectious complications developed in only 12 patients in each group (4.7 percent). In 53 patients the mean serum concentration of ceftriaxone 24 hours after administration of the 2 g dose was 37.4 micrograms/ml, a level far in excess of the minimal inhibitory concentrations of usual cardiovascular pathogens with the exception of Bacteroides species and Pseudomonas species. We conclude that a single 2 g dose of ceftriaxone given at the time of cardiovascular surgery should provide adequate prophylaxis.
mesh_terms: D001424:Bacterial Infections / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures; D002439:Cefotaxime / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D002443:Ceftriaxone; D002444:Cefuroxime / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control; D011897:Random Allocation; D018805:Sepsis / Q000517:prevention & control; D013530:Surgical Wound Infection / Q000517:prevention & control; D013997:Time Factors; D014552:Urinary Tract Infections / Q000517:prevention & control; D014656:Vascular Surgical Procedures
chemical_list: D002443:Ceftriaxone; D002439:Cefotaxime; D002444:Cefuroxime