Pharmacokinetics of ampicillin/sulbactam in patients undergoing colorectal surgery: measurements in serum, the colonic wall and in tissue at the incision site.
The concentrations of ampicillin and sulbactam were determined in serum, colonic wall and incision site tissues from 23 patients undergoing elective colorectal surgery after infusion of a high-dose regimen (2 g ampicillin/1 g sulbactam) or a low-dose regimen (1 g ampicillin/0.5 g sulbactam). The results confirmed that ampicilin and sulbactam penetrated well into the tissues studied and reached therapeutically effective concentrations at the various sites. The high dose regimen showed higher concentrations of both compounds in serum and tissues, indicating a longer period of perioperative protection against bacterial pathogens. Thus, about 39 min after the end of the infusion of the high-dose regimen, the mean concentration of ampicillin was 68.8 +/- 31.2 mug/g and of sulbactam 23.4 +/- 6.3 mug/g in the tissue of the colonic wall. Low-dose prophylaxis, showing mean tissue concentrations of ampicillin of 35.6 +/- 7.0 mug/g and of sulbactam of 14.2 +/- 2.4 mug/g about 48 min after the infusion, is appropriate if the duration surgery does not significantly exceed 2 h.
Wenzel
M
M
Department of Surgery, Zehlendorf Hospital, Berlin, Germany.
Wildfeuer
A
A
Gutsche
F
F