DiPiro J T, Connors J E, Bowden T A, Stanfield J A, Lampert B M, Stewart J T
University of Georgia College of Pharmacy, Augusta.
J Antimicrob Chemother. 1989 Apr;23 Suppl D:89-95. doi: 10.1093/jac/23.suppl_d.89.
We determined the intraoperative concentrations of cefmetazole and cefoxitin in serum and muscle from the wound of 30 patients who were undergoing cholecystectomies. The study employed an open-label design in which all patients randomly received cefoxitin sodium (30 mg/kg) or cefmetazole sodium (15 or 30 mg/kg) intravenously with the induction of anesthesia. Total serum and wound-muscle concentrations achieved with cefmetazole 30 mg/kg were significantly greater than those achieved with a similar dose of cefoxitin. Cefmetazole in a 15 mg/kg dose was comparable with cefoxitin 30 mg/kg in achieved concentrations. The elimination half-life for cefoxitin was much shorter than that for cefmetazole (41 min v. 64-68 min, respectively) and this relates to a shorter duration of action for the former. The choice of agent for surgical prophylaxis should incorporate factors relating to drug pharmacokinetic properties as well as microbiological factors.
我们测定了30例接受胆囊切除术患者血清及伤口肌肉中头孢美唑和头孢西丁的术中浓度。本研究采用开放标签设计，所有患者在麻醉诱导时随机静脉注射头孢西丁钠（30mg/kg）或头孢美唑钠（15或30mg/kg）。头孢美唑30mg/kg达到的总血清和伤口肌肉浓度显著高于相似剂量的头孢西丁。15mg/kg剂量的头孢美唑在达到的浓度方面与30mg/kg的头孢西丁相当。头孢西丁的消除半衰期比头孢美唑短得多（分别为41分钟和64 - 68分钟），这与前者作用持续时间较短有关。手术预防用药的选择应综合考虑药物的药代动力学特性以及微生物学因素。
