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Ann Thorac Surg 1981;31:155-160
© 1981 The Society of Thoracic Surgeons

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Articles

A Comparison of the Penetration Characteristics of Cephapirin and Cephalothin into Right Atrial Appendage, Muscle, Fat, and Pericardial Fluid of Pediatric Patients Undergoing Open-Heart Operation

Departments of Pharmacy, Cardiovascular Surgery, and Pediatrics of the State University of New York at Buffalo and Children's Hospital of Buffalo, Buffalo, NY, and the Division of Infectious Disease, Hartford Hospital, Hartford, CT

Accepted for publication May 21, 1980.

^* Address reprint requests to Dr. Quintiliani, Director, Division of Infectious Disease, Hartford Hospital, Hartford, CT 06115

Thirty-two pediatric patients having open-heart operation received a single dose of either cephalothin or cephapirin intravenously, 30 mg per kilogram of body weight, in the operating room, for prophylaxis before the chest cavity was opened. Samples of right atrial appendage, pericardial fluid, muscle, fat, and plasma were obtained at various time intervals after injection of the antibiotics, and assayed for cephalosporin concentration.

The concentration-time profiles of cephalothin and cephapirin in atrial appendage, muscle, fat, and plasma were identical. Cephapirin produced higher total and free concentrations in pericardial fluid compared with cephalothin. This presumably was due to the lower protein binding of cephapirin. Antibiotic concentrations above the minimal inhibitory concentration for Staphylococcus aureus and S. epidermidis were present in myocardial tissue for at least 90 minutes after the dose was administered.

These data support the need to administer these antibiotics shortly before surgical intervention and, if the operation is prolonged, the need to administer a second dose of antibiotic.

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				H. Faden Prophylactic Antibiotics in Pediatric Cardiovascular Surgery: Current Practices Ann. Thorac. Surg., March 1, 1981; 31(3): 211 - 213. [Abstract] [PDF]