A comparison of the penetration characteristics of latamoxef and cephalothin into the right atrial appendage and pericardial fluid of adult patients undergoing open-heart surgery
Sato, Y.; Kanazawa, H.; Okazaki, H.; Kosuge, T.; Imaizumi, K.; Eguchi, S.
Japanese Journal of Antibiotics 37(4): 671-679
1984
ISSN/ISBN: 0368-2781 PMID: 6471383 Document Number: 236593
A comparative study of the serum, atrial muscle, and pericardial fluid concentrations of latamoxef (LMOX) and cephalothin (CET) was performed in 18 adult patients having cardiac surgery. Patients were randomly assigned to receive either a single dose of CET 30 mg/kg, LMOX 30 mg/kg, or LMOX 20 mg/kg. Each drug was administered intravenously soon after anesthetic maintenance was achieved. After each drug administration, serum samples were obtained at various time intervals before, during, and after extracorporeal circulation (ECC), and assayed for CET and LMOX concentration. A sample of pericardial fluid was collected immediately after the pericardium was opened. The right atrial appendage tissue samples were obtained at the time of heart cannulation. The pharmacokinetics and penetration characteristics of each drug were analysed by the method of two-compartment model. Serum concentrations of CET following a single intravenous injection of 30 mg/kg were the high values, 172.4 +/- 35.6 micrograms/ml at 5 minutes, and 92.9 +/- 33.8 micrograms/ml at 15 minutes after injection. The initial (before bypass) half-life was 0.22 +/- 0.11 hour (13.1 minutes) while half-lives during and after ECC were prolonged significantly. In the cases of CET group, the myocardial tissue concentration value of 4.86 micrograms/g was obtained in only 1 case. The mean pericardial fluid concentration was 4.69 +/- 3.35 micrograms/ml at 5 to 30 minutes after injection. Serum concentration of LMOX following a injection of 30 mg/kg were 253.6 +/- 67.4 micrograms/ml at 5 minutes, and 176.3 +/- 64.1 micrograms/ml at 15 minutes after injection.