Cephalosporins for prophylaxis in operative repair of femoral fractures. Levels in serum, muscle, and hematoma
Jones, S.; DiPiro, J.T.; Nix, D.E.; Bhatti, N.A.
Journal of Bone and Joint Surgery. American Volume 67(6): 921-924
1985
ISSN/ISBN: 0021-9355 PMID: 4019541 Document Number: 246891
We conducted a prospective controlled study of thirty patients who had an open reduction with internal fixation of a closed fracture of the femur. Each patient received cefamandole, cefazolin, or cefoxitin intravenously (twenty-five milligrams per kilogram of body weight) on entry into the operating room. Intraoperatively, samples of blood, muscle, and organizing hematoma were collected for determination of levels of the antimicrobial agent. Throughout the operation, cefazolin was shown to result in significantly higher levels in serum. The mean concentrations in muscle were similar for all three drugs, but the levels in the hematoma were twice as high with cefazolin as with cefamandole or cefoxitin. No correlation was evident between the concentration of any of these antibiotics in the hematoma and the interval between injury and operation.