Pharmacokinetics of three-dose cefoxitin prophylaxis in caesarean section
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A pharmacokinetic analysis of cefoxitin in women undergoing caesarean section under general anaesthesia, was performed. In order to prevent infections postoperatively three doses of cefoxitin -2,1 and 1 g, respectively — were given as a 3-min intravenous infusion at 6-h intervals.In vitro growth of most pathogens is inhibited at a cefoxitin concentration of 16 μg/ml. In the sera of the patients, this antibiotic level was maintained for a period of 90–100 min after the first administration (2 g) and 45–50 min after the second and the third administration of cefoxitin (1 g). The period of subinhibitory antibiotic concentrations lasted 270 and 315 min, respectively. How can one reach prolonged antibiotic coverage? In order to minimize antibiotic pressure on hospital flora it is advisable not to increase the total amount of antibiotic (4 g) administered. By starting a 310 mg/h infusion after the initial 2 g bolus injection, the serum concentration of cefoxitin can be maintained at a minimum level of 16 μg/ml during a period of 6.5 h. The improvement of antibiotic administration suggested requires further clinical testing.
KeywordsAdministration, intravenous Cefoxitin Cesarean section Pharmacokinetics Serum concentrations
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- 2.Hawrylyshyn PA, Bernstein P, Papsin FR. Short-term prophylaxis in high-risk patients following caesarean section. Am J Obstet Gynecol 1983;45:285–90.Google Scholar
- 3.Jaffe R, Altaros M, Ben-Aderet N. Mezlocillin prophylaxis in emergency caesarean section. Chemotherapy 1986;2:173–8.Google Scholar
- 4.McGregor JA, French JI, Mackowski E. Single-dose cefotetan versus multidose cefoxitin prophylaxis in caesarean section in high-risk patients. Obstet Gynecol 1986;154:955–64.Google Scholar
- 5.Roex AJM, Puyenbroek JI, Van Loenen AC, Arts NFTh. Single-versus three-dose cefoxitin prophylaxis in caesarean section: a randomized clinical trial. Eur J Obst Gynecol Reprod Biol 1987;25:293–9.Google Scholar
- 12.Van Loenen AC, Roex AJM, Willems HJJ, De Goede PNFC, Van Dijk A. Farmacokinetiek van cefoxitine bij sectio caesarea [Pharmacokinetics of cefoxitin in caesarean section]. Ziekenhuisfarmacie 1987;3:47–51.Google Scholar
- 13.Runciman WB, Mather LE. Effects of anaesthesia on drug disposition. In: Feldman SA, Scurr CF, Paton W, eds. Drugs in anaesthesia. London: Edward Arnold, 1987:170–6.Google Scholar