Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1996 Mar;40(3):812–815. doi: 10.1128/aac.40.3.812

Penetration of ceftriaxone (1 or 2 grams intravenously) into mediastinal and cardiac tissues in humans.

C Martin 1, X Viviand 1, M Alaya 1, F Lokiec 1, K Ennabli 1, R Said 1, M Pecking 1
PMCID: PMC163208  PMID: 8851621

Abstract

Penetration of ceftriaxone into heart tissues (valves, myocardium, auricles, and pericardium) and mediastinal tissues (fat and sternal bone) was evaluated after two regimens of ceftriaxone administration. Ten patients (group 1) were given 1,000 mg of ceftriaxone intravenously 30 min before anesthesia. Ten other patients (group 2) received the same dose and then a second 1,000-mg dose at the time of initiation of cardiopulmonary bypass. Similar and very satisfactory penetrations of ceftriaxone into tissue were observed for both groups. During opening and closure of the thorax, mean ceftriaxone concentration was in excess of the MIC at which 90% of the potential pathogens were inhibited (> or = 4 micrograms/g) in the thoracic fat, the sternal bone, and the pericardium. No significant differences between the two administration regimens in penetration of ceftriaxone into tissue were observed. During cardiopulmonary bypass, the ceftriaxone concentration was > or = 4 micrograms/g in the myocardium, the endocardium, and the auricle. The regimen of ceftriaxone administration did not significantly influence penetration of the drug into heart tissues. However, for some patients in the two groups and mainly in the sternal bone at the time of thorax closure (6 patients in group 1 and 5 patients in group 2), ceftriaxone levels in tissues were less than the MICs (4 micrograms/g) for some potential pathogens (methicillin-susceptible Staphylococcus aureus and methicillin-susceptible Staphylococcus epidermidis). During the different steps of the surgical procedures, all (10 of 10) patients in each group had tissue ceftriaxone levels greater than the MICs for gram-negative aerobic bacilli (0.1 microgram/g), except for Pseudomonas spp.

Full Text

The Full Text of this article is available as a PDF (205.2 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bayer A. S., Nelson R. J., Slama T. G. Current concepts in prevention of prosthetic valve endocarditis. Chest. 1990 May;97(5):1203–1207. doi: 10.1378/chest.97.5.1203. [DOI] [PubMed] [Google Scholar]
  2. Bergamini T. M., Polk H. C., Jr The importance of tissue antibiotic activity in the prevention of operative wound infection. J Antimicrob Chemother. 1989 Mar;23(3):301–313. doi: 10.1093/jac/23.3.301. [DOI] [PubMed] [Google Scholar]
  3. Brogden R. N., Ward A. Ceftriaxone. A reappraisal of its antibacterial activity and pharmacokinetic properties, and an update on its therapeutic use with particular reference to once-daily administration. Drugs. 1988 Jun;35(6):604–645. doi: 10.2165/00003495-198835060-00002. [DOI] [PubMed] [Google Scholar]
  4. Burke J. F. The effective period of preventive antibiotic action in experimental incisions and dermal lesions. Surgery. 1961 Jul;50:161–168. [PubMed] [Google Scholar]
  5. Classen D. C., Evans R. S., Pestotnik S. L., Horn S. D., Menlove R. L., Burke J. P. The timing of prophylactic administration of antibiotics and the risk of surgical-wound infection. N Engl J Med. 1992 Jan 30;326(5):281–286. doi: 10.1056/NEJM199201303260501. [DOI] [PubMed] [Google Scholar]
  6. Dasta J. F., Jacobi J., Wu L. S., Sokoloski T., Beckley P., Reilley T. E., Howie M. B. Loss of nitroglycerin to cardiopulmonary bypass apparatus. Crit Care Med. 1983 Jan;11(1):50–52. doi: 10.1097/00003246-198301000-00013. [DOI] [PubMed] [Google Scholar]
  7. Geroulanos S., Donfried B., Turina M. Plasma levels of ceftriaxone in cardiovascular surgery. Am J Surg. 1984 Oct 19;148(4A):5–7. [PubMed] [Google Scholar]
  8. Jungbluth G. L., Pasko M. T., Beam T. R., Jusko W. J. Ceftriaxone disposition in open-heart surgery patients. Antimicrob Agents Chemother. 1989 Jun;33(6):850–856. doi: 10.1128/aac.33.6.850. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Kaiser A. B. Antimicrobial prophylaxis in surgery. N Engl J Med. 1986 Oct 30;315(18):1129–1138. doi: 10.1056/NEJM198610303151805. [DOI] [PubMed] [Google Scholar]
  10. Klamerus K. J., Rodvold K. A., Silverman N. A., Levitsky S. Effect of cardiopulmonary bypass on vancomycin and netilmicin disposition. Antimicrob Agents Chemother. 1988 May;32(5):631–635. doi: 10.1128/aac.32.5.631. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Knapp C. C., Sierra-Madero J., Washington J. A. Antibacterial activities of cefpodoxime, cefixime, and ceftriaxone. Antimicrob Agents Chemother. 1988 Dec;32(12):1896–1898. doi: 10.1128/aac.32.12.1896. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Koren G., Crean P., Klein J., Goresky G., Villamater J., MacLeod S. M. Sequestration of fentanyl by the cardiopulmonary bypass (CPBP). Eur J Clin Pharmacol. 1984;27(1):51–56. doi: 10.1007/BF00553154. [DOI] [PubMed] [Google Scholar]
  13. Martin C., Alaya M., Mallet M. N., Viviand X., Ennabli K., Said R., De Micco P. Penetration of vancomycin into mediastinal and cardiac tissues in humans. Antimicrob Agents Chemother. 1994 Feb;38(2):396–399. doi: 10.1128/aac.38.2.396. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Martin C. Antimicrobial prophylaxis in surgery: general concepts and clinical guidelines. French Study Group on Antimicrobial Prophylaxis in Surgery, French Society of Anesthesia and Intensive Care. Infect Control Hosp Epidemiol. 1994 Jul;15(7):463–471. doi: 10.1086/646952. [DOI] [PubMed] [Google Scholar]
  15. Martin C., Ragni J., Lokiec F., Guillen J. C., Auge A., Pecking M., Gouin F. Pharmacokinetics and tissue penetration of a single dose of ceftriaxone (1,000 milligrams intravenously) for antibiotic prophylaxis in thoracic surgery. Antimicrob Agents Chemother. 1992 Dec;36(12):2804–2807. doi: 10.1128/aac.36.12.2804. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Mutch D., Richards G., Brown R. A., Mulder D. S. Bioactive antibiotic levels in the human aorta. Surgery. 1982 Dec;92(6):1068–1071. [PubMed] [Google Scholar]
  17. Pitkin D. H., Sachs C., Zajac I., Actor P. Distribution of sodium cefazolin in serum, muscle, bone marrow, and bone of normal rabbits. Antimicrob Agents Chemother. 1977 Apr;11(4):760–762. doi: 10.1128/aac.11.4.760. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Stanbridge T. N., Greenall D. J. Netilmicin prophylaxis in open-heart surgery. J Antimicrob Chemother. 1984 Jan;13 (Suppl A):59–65. doi: 10.1093/jac/13.suppl_a.59. [DOI] [PubMed] [Google Scholar]
  19. Stone H. H. Basic principles in the use of prophylactic antibiotics. J Antimicrob Chemother. 1984 Sep;14 (Suppl B):33–37. doi: 10.1093/jac/14.suppl_b.33. [DOI] [PubMed] [Google Scholar]
  20. Stratton C. W., Liu C., Weeks L. S. Activity of LY146032 compared with that of methicillin, cefazolin, cefamandole, cefuroxime, ciprofloxacin, and vancomycin against staphylococci as determined by kill-kinetic studies. Antimicrob Agents Chemother. 1987 Aug;31(8):1210–1215. doi: 10.1128/aac.31.8.1210. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Washington J. A., 2nd The effects and significance of subminimal inhibitory concentrations of antibiotics. Rev Infect Dis. 1979 Sep-Oct;1(5):781–786. doi: 10.1093/clinids/1.5.781. [DOI] [PubMed] [Google Scholar]

Articles from Antimicrobial Agents and Chemotherapy are provided here courtesy of American Society for Microbiology (ASM)

RESOURCES