title: Antibiotic prophylaxis with cefazolin and gentamicin in cardiac surgery for children less than ten kilograms.
abstract: OBJECTIVE
  Antibiotic prophylaxis is recommended in pediatric cardiac surgery, but no data concerning the current antibiotic regimen were available.
  
  
  METHODS
  Prospective study from April to June 2000.
  
  
  METHODS
  University hospital operating room and postoperative intensive care unit.
  
  
  METHODS
  Nineteen consecutive infants less than 10 kg with normal renal function undergoing cardiac surgery with cardiopulmonary bypass longer than 30 minutes.
  
  
  METHODS
  Intravenous administration of cefazolin, 40 mg/kg, and gentamicin, 5 mg/kg, at induction of anesthesia; followed by cefazolin, 35 mg/kg every 8 hours, and gentamicin, 2 mg/kg every 12 hours, over 48 hours.
  
  
  RESULTS
  Levels of serum antibiotics were measured: cefazolin (microbiologic) and gentamicin (fluorescence immunoassay) with 8 intraoperative and 5 postoperative samplings. Intraoperatively, cefazolin levels decreased from 166 +/- 44 (mean +/- standard deviation) down to 54 +/- 16 microg/mL and gentamicin from 20.8 +/- 9.5 down to 5.9 +/- 1.5 microg/mL. The postoperative trough levels were 12 +/- 7, 15 +/- 10, and 19 +/- 22 microg/mL for cefazolin and 1.1 +/- 0.5, 0.8 +/- 0.4, and 0.8 +/- 0.9 microg/mL for gentamicin.
  
  
  CONCLUSIONS
  Antibiotic serum levels are consistent with satisfactory efficacy, but intraoperative gentamicin peak levels appeared too high.
authors.affiliation: Service d'Anesthésie-Réanimation and Equipe d'Accueil 1896, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France.
authors.forename: Denis
authors.initials: D
authors.lastname: Haessler
authors.forename: Marie-Elisabeth
authors.initials: ME
authors.lastname: Reverdy
authors.forename: Jean
authors.initials: J
authors.lastname: Neidecker
authors.forename: Pierre
authors.initials: P
authors.lastname: Brûlé
authors.forename: Jean
authors.initials: J
authors.lastname: Ninet
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Lehot
mesh_terms: D000900:Anti-Bacterial Agents / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis; D006348:Cardiac Surgical Procedures; D002437:Cefazolin / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000097:blood / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006331:Heart Diseases / Q000151:congenital / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins; D002437:Cefazolin