title: Pharmacokinetics and tissue penetration of vancomycin in patients undergoing prosthetic mammary surgery.
abstract: Vancomycin concentrations in periprosthetic breast tissues were evaluated in 24 women undergoing reconstructive surgery after mastectomy for breast cancer. Patients were given a single prophylactic dose of vancomycin (1 g iv) 1-8 h before surgery, and mean capsular and pericapsular tissue concentrations were measured by HPLC. Vancomycin was not detectable in the majority of patients belonging to the 1-3 h post-dose groups, whereas in the 4-8 h post-dose groups, mean capsular and pericapsular concentrations were as follows: at 4 h, 4.0 mg/kg and 5.9 mg/kg; at 6 h, 4.1 mg/kg and 4. 8 mg/kg; at 8 h, 5.9 mg/kg and 11.1 mg/kg, respectively. Vancomycin tissue concentrations thus were equal to or exceeded the breakpoint of 4 mg/L in most samples collected 4-8 h after dosing. In conclusion, our data suggest that appropriate timing of vancomycin prophylaxis should be considered to allow the maintenance of adequate tissue concentrations throughout the surgical procedure.
authors.affiliation: Department of Immunology and Infectious Diseases, Università ed Azienda Ospedaliera di Verona, Italy. luzzati@borgotrento.univr.it
authors.forename: R
authors.initials: R
authors.lastname: Luzzati
authors.forename: A
authors.initials: A
authors.lastname: Sanna
authors.forename: B
authors.initials: B
authors.lastname: Allegranzi
authors.forename: S
authors.initials: S
authors.lastname: Nardi
authors.forename: M
authors.initials: M
authors.lastname: Berti
authors.forename: D
authors.initials: D
authors.lastname: Barisoni
authors.forename: E
authors.initials: E
authors.lastname: Concia
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics*; D019928:Breast Implantation; D002851:Chromatography, High Pressure Liquid; D005260:Female; D006801:Humans; D008875:Middle Aged; D014640:Vancomycin / Q000493:pharmacokinetics*
chemical_list: D000900:Anti-Bacterial Agents; D014640:Vancomycin