Skip to main content
NCBI home page
Antimicrobial Agents and Chemotherapy logoLink to Antimicrobial Agents and Chemotherapy
. 1990 Oct;34(10):1921–1924. doi: 10.1128/aac.34.10.1921

Pharmacokinetics and tissue penetration of a single dose of ornidazole (1,000 milligrams intravenously) for antibiotic prophylaxis in colorectal surgery.

C Martin 1, B Bruguerolle 1, M N Mallet 1, M Condomines 1, B Sastre 1, F Gouin 1
PMCID: PMC171965  PMID: 2291657

Abstract

Levels in serum and tissue penetration of ornidazole were studied after a single intravenous injection of 1,000 mg given to 14 patients for prophylaxis of surgical infection. They were scheduled for elective colorectal surgery. Adequate levels in blood (greater than or equal to MIC for 90% of Bacteroides fragilis strains tested) were found in all patients throughout the procedure and up to hour 24. Mean-maximal (15 min) and last-determined (24 h) ornidazole levels in serum were 24 +/- 5.2 and 6.3 +/- 1.4 mg/liter, respectively. beta-Phase elimination half-life was 14.1 +/- 2.7 h, and clearance and apparent volume of distribution were 47 +/- 12 ml/min and 0.9 +/- 0.13 liters/kg, respectively. In all patient, adequate levels in tissue were found in the abdominal wall and the epiploic fat at time of incision and in the colonic wall at time of anastomosis. At time of closure, all but one patient had adequate levels in tissue in the abdominal wall and the epiploic fat. No anaerobic nor aerobic infection occurred in the study patients.

Full text

PDF
1921

Selected References

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

  1. Bartlett S. P., Burton R. C. Effects of prophylactic antibiotics on wound infection after elective colon and rectal surgery: 1960 to 1980. Am J Surg. 1983 Feb;145(2):300–309. doi: 10.1016/0002-9610(83)90088-0. [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. Brass C., Richards G. K., Ruedy J., Prentis J., Hinchey E. J. The effect of metronidazole on the incidence of postoperative wound infection in elective colon surgery. Am J Surg. 1978 Jan;135(1):91–96. doi: 10.1016/0002-9610(78)90016-8. [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. Condon R. E., Bartlett J. G., Nichols R. L., Schulte W. J., Gorbach S. L., Ochi S. Preoperative prophylactic cephalothin fails to control septic complications of colorectal operations: results of controlled clinical trial. A Veterans Administration cooperative study. Am J Surg. 1979 Jan;137(1):68–74. doi: 10.1016/0002-9610(79)90013-8. [DOI] [PubMed] [Google Scholar]
  6. Conte J. E., Jr, Cohen S. N., Roe B. B., Elashoff R. M. Antibiotic prophylaxis and cardiac surgery. A prospective double-blind comparison of single-dose versus multiple-dose regimens. Ann Intern Med. 1972 Jun;76(6):943–949. doi: 10.7326/0003-4819-76-6-943. [DOI] [PubMed] [Google Scholar]
  7. DiPiro J. T., Cheung R. P., Bowden T. A., Jr, Mansberger J. A. Single dose systemic antibiotic prophylaxis of surgical wound infections. Am J Surg. 1986 Nov;152(5):552–559. doi: 10.1016/0002-9610(86)90228-x. [DOI] [PubMed] [Google Scholar]
  8. Eykyn S. J., Jackson B. T., Lockhart-Mummery H. E., Phillips I. Prophylactic peroperative intravenous metronidazole in elective colorectal surgery. Lancet. 1979 Oct 13;2(8146):761–764. doi: 10.1016/s0140-6736(79)92114-7. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Guglielmo B. J., Hohn D. C., Koo P. J., Hunt T. K., Sweet R. L., Conte J. E., Jr Antibiotic prophylaxis in surgical procedures. A critical analysis of the literature. Arch Surg. 1983 Aug;118(8):943–955. doi: 10.1001/archsurg.1983.01390080045013. [DOI] [PubMed] [Google Scholar]
  10. Hunt P. S., Francis J. K., Peck G., Farrell K., Sali A. Tinidazole in the prevention of wound infection after elective colorectal surgery. Med J Aust. 1979 Feb 24;1(4):107–109. doi: 10.5694/j.1326-5377.1979.tb112039.x. [DOI] [PubMed] [Google Scholar]
  11. 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]
  12. Keighley M. R., Arabi Y., Alexander-Williams J., Youngs D., Burdon D. W. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. Lancet. 1979 Apr 28;1(8122):894–897. doi: 10.1016/s0140-6736(79)91373-4. [DOI] [PubMed] [Google Scholar]
  13. Keighley M. R., Crapp A. R., Burdon D. W., Cooke W. T., Alexander-Williams J. Prophylaxis against anaerobic sepsis in bowel surgery. Br J Surg. 1976 Jul;63(7):538–541. doi: 10.1002/bjs.1800630711. [DOI] [PubMed] [Google Scholar]
  14. Kling P. A., Holmlund D., Burman L. G. Single-dose intravenous metronidazole v. doxycycline prophylaxis in colorectal surgery. An open prospective, randomized trial. Acta Chir Scand. 1985;151(2):163–168. [PubMed] [Google Scholar]
  15. Kosmidis J., Stathakis C., Mantopoulos K., Pouriezi T., Papathanassiou B., Daikos G. K. Clinical pharmacology of cefotaxime including penetration into bile, sputum, bone and cerebrospinal fluid. J Antimicrob Chemother. 1980 Sep;6 (Suppl A):147–151. doi: 10.1093/jac/6.suppl_a.147. [DOI] [PubMed] [Google Scholar]
  16. Lorian V. Low concentrations of antibiotics. J Antimicrob Chemother. 1985 Jan;15 (Suppl A):15–26. doi: 10.1093/jac/15.suppl_a.15. [DOI] [PubMed] [Google Scholar]
  17. Merdjan H., Bonnat C., Singlas E., Diquet B. Measurement of ornidazole by high-performance liquid chromatography. J Chromatogr. 1983 Apr 8;273(2):475–480. doi: 10.1016/s0378-4347(00)80974-3. [DOI] [PubMed] [Google Scholar]
  18. Mitchell N. J., Evans D. S., Pollock D. Single dose metronidazole with and without cefuroxime in elective colorectal surgery. Br J Surg. 1983 Nov;70(11):668–669. doi: 10.1002/bjs.1800701109. [DOI] [PubMed] [Google Scholar]
  19. Mittermayer H., Gross C., Brücke P. Single dose cefuroxime/metronidazole versus metronidazole alone in elective colorectal surgery. Am Surg. 1984 Aug;50(8):418–423. [PubMed] [Google Scholar]
  20. 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]
  21. Pitt H. A., Roberts R. B., Johnson W. D., Jr Gentamicin levels in the human biliary tract. J Infect Dis. 1973 Mar;127(3):299–302. doi: 10.1093/infdis/127.3.299. [DOI] [PubMed] [Google Scholar]
  22. Ralph E. D. Clinical pharmacokinetics of metronidazole. Clin Pharmacokinet. 1983 Jan-Feb;8(1):43–62. doi: 10.2165/00003088-198308010-00003. [DOI] [PubMed] [Google Scholar]
  23. Taburet A. M., Delion F., Attali P., Thebault J. J., Singlas E. Pharmacokinetics of ornidazole in patients with severe liver cirrhosis. Clin Pharmacol Ther. 1986 Sep;40(3):359–364. doi: 10.1038/clpt.1986.189. [DOI] [PubMed] [Google Scholar]
  24. Tally F. P., Cuchural G. J., Jr, Jacobus N. V., Gorbach S. L., Aldridge K., Cleary T., Finegold S. M., Hill G., Iannini P., O'Keefe J. P. Nationwide study of the susceptibility of the Bacteroides fragilis group in the United States. Antimicrob Agents Chemother. 1985 Nov;28(5):675–677. doi: 10.1128/aac.28.5.675. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. 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]
  26. Zak O., Kradolfer F. Effects of subminimal inhibitory concentrations of antibiotics in experimental infections. Rev Infect Dis. 1979 Sep-Oct;1(5):862–879. doi: 10.1093/clinids/1.5.862. [DOI] [PubMed] [Google Scholar]

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

RESOURCES