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International Journal of Clinical Pharmacy

, Volume 38, Issue 4, pp 771–775 | Cite as

The pharmacokinetics of ampicillin–sulbactam in anuric patients: dosing optimization for prophylaxis during cardiovascular surgery

  • Yuta Yokoyama
  • Kazuaki Matsumoto
  • Kazuro Ikawa
  • Erika Watanabe
  • Hiroyuki Yamamoto
  • Yutaka Imoto
  • Norifumi Morikawa
  • Yasuo TakedaEmail author
Short Research Report

Abstract

Background The administration of antibiotic prophylaxis during cardiothoracic surgery can reduce the rate of surgical site infections. Trials of cardiothoracic antibiotic prophylaxis have found it to be beneficial in preventing postoperative wound infections. Objective To determine the more appropriate timing of repeated doses of ampicillin–sulbactam to maintain adequate antibiotic concentrations during cardiovascular surgery in anuric patients. Method Five adult anuric dialysis patients who received ampicillin–sulbactam during cardiovascular surgery at Kagoshima University Hospital, the total plasma concentrations of ampicillin and sulbactam were monitored after ampicillin (1 g)–sulbactam (0.5 g) administration. Pharmacokinetic parameters were estimated and used to predict the free plasma concentrations of ampicillin and sulbactam. Results The mean values for the volume of distribution, total clearance, elimination rate constant and the elimination half-life for ampicillin were 8.9 ± 2.4 L, 1.69 ± 0.93 L/h, 0.180 ± 0.059 h−1 and 4.23 ± 1.48 h, respectively. The pharmacokinetic parameters were similar to those of sulbactam. When ampicillin (1 g)–sulbactam (0.5 g) was intravenously administered at 8, 12 and 24 h intervals, the predicted free trough plasma concentrations of ampicillin were 28.72, 12.06 and 1.25 μg/mL, respectively. Conclusion We suggest that ampicillin (1 g)–sulbactam (0.5 g) should be intravenously administered every 12 h in order to maintain a free ampicillin concentration of more than 12 μg/mL in anuric patients during cardiovascular surgery.

Keywords

Ampicillin–sulbactam Anuria Cardiovascular surgery Prophylaxis 

Notes

Acknowledgments

The authors would like to thank medical staff at operation department in Kagoshima University Hospital for assisting blood sample collection during cardiovascular surgery.

Funding

This study did not receive special funding.

Conflicts of interest

None.

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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Yuta Yokoyama
    • 1
    • 2
  • Kazuaki Matsumoto
    • 1
  • Kazuro Ikawa
    • 2
  • Erika Watanabe
    • 2
  • Hiroyuki Yamamoto
    • 3
  • Yutaka Imoto
    • 3
  • Norifumi Morikawa
    • 2
  • Yasuo Takeda
    • 1
    Email author
  1. 1.Department of Clinical Pharmacy and Pharmacology, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
  2. 2.Department of Clinical PharmacotherapyHiroshima UniversityHiroshimaJapan
  3. 3.Department of Thoracic, Cardiovascular and Hepato-Biliary-Pancreatic Surgery, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan

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