Preincisional single-dose ceftriaxone for the prophylaxis of surgical wound infection.
BACKGROUND
Preincisional intraparietal injection of antibiotics is used for the prophylaxis of postoperative surgical infections. Whether topically injected antibiotics remain primarily in the surgical wound or are systematically absorbed is uncertain, however.


METHODS
The pharmacokinetics of preincisional injection of 2 g ceftriaxone were studied in 20 patients who have undergone abdominal surgery, with determination of serum, wound tissue, and wound fluid antibiotic concentrations.


RESULTS
Preincisional injection of ceftriaxone resulted in high antibiotic concentrations in the wound tissue and wound fluid. The highest plasma concentrations were achieved at 1.50 hours (99.47 +/- 14.67 micrograms/mL). Plasma concentrations exceeded the minimal inhibitory concentrations of most aerobic gram-positive and gram-negative organisms with the exception of Pseudomonas aeruginosa, Acinetobacter species, and Streptococcus faecalis for 24 hours (10.42 +/- 4.12). No local or general complications arose in any of the patients.


CONCLUSIONS
Our results suggest that preincisional administration of ceftriaxone for prophylaxis is very effective.
Chalkiadakis
G E
GE
Department of Surgery, University of Crete School of Medicine, Greece.
Gonnianakis
C
C
Tsatsakis
A
A
Tsakalof
A
A
Michalodimitrakis
M
M
D000328:Adult; D000368:Aged; D019072:Antibiotic Prophylaxis; D002443:Ceftriaxone / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D002511:Cephalosporins / Q000008:administration & dosage / Q000097:blood / Q000493:pharmacokinetics* / Q000627:therapeutic use*; D002851:Chromatography, High Pressure Liquid; D013505:Digestive System Surgical Procedures; D006801:Humans; D007279:Injections, Subcutaneous; D008875:Middle Aged; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000517:prevention & control*; D016896:Treatment Outcome
D002511:Cephalosporins; D002443:Ceftriaxone