title: Suitability of cefotiam and cefuroxime axetil for the perioperative short-term prophylaxis in tonsillectomy patients.
abstract: The efficacy of the perioperative short-term prophylaxis with cefotiam (CAS 66309-69-1) and cefuroxime axetil (CAS 64544-07-6) was analysed by the assessment of the pharmacological kinetics in the serum and the tonsil tissue in 50 patients with recurrent tonsillitis. Twenty-four patients received 1 g cefotiam by the intravenous route 30 min to 4 h before the tonsillectomy, and 26 patients received 250 mg cefuroxime axetil orally 1 to 6 h before the tonsillectomy. Bactericidal serum levels were reached for cefotiam up to 4 h after intravenous application and for cefuroxime axetil up to 3 h after oral application. In the tissue of the tonsil there were proved levels which were definitely above the MIC 90 (MIC = minimum inhibitory concentration) known for the clinically relevant germs for cefotiam after 30 min up to 2 h, for cefuroxime axetil after only 2 h. Considering the distribution areas, the capacity of the protein binding and the microbiological measuring methods, one can expect an efficient antibiotic coverage after an intravenous one-shot bolus injection of 1 g cefotiam from 30 min to 4 h and after oral application of 250 mg cefuroxime axetil on an empty stomach from 1 to 6 h. Because of the short duration of a tonsillectomy and the serum and tonsil tissue kinetics cefotiam and cefuroxime axetil are suitable for the perioperative antibiotic prophylaxis of high-risk patients.
authors.affiliation: Department of Otorhinolaryngology, University Hospital Carl Gustav Carus, Technical University, Dresden, Germany. Rainer.Mueller2@mailbox.tu-dresden.de
authors.forename: Rainer
authors.initials: R
authors.lastname: Müller
authors.forename: Christina
authors.initials: C
authors.lastname: Böttger
authors.forename: Georg
authors.initials: G
authors.lastname: Wichmann
mesh_terms: D000293:Adolescent; D000328:Adult; D019072:Antibiotic Prophylaxis; D015310:Cefotiam / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002444:Cefuroxime / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D002511:Cephalosporins / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008826:Microbial Sensitivity Tests; D014066:Palatine Tonsil / Q000378:metabolism; D011183:Postoperative Complications / Q000382:microbiology / Q000517:prevention & control*; D014068:Tonsillectomy
chemical_list: D002511:Cephalosporins; D015310:Cefotiam; D002444:Cefuroxime