Green E R, Subramanian S, Faden H, Quintiliani R, Nightingale C H
Ann Thorac Surg. 1981 Feb;31(2):155-60. doi: 10.1016/s0003-4975(10)61535-4.
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.
32名接受心脏直视手术的儿科患者在手术室静脉注射单剂量头孢噻吩或头孢匹林，剂量为每公斤体重30毫克，用于在打开胸腔前进行预防。在注射抗生素后的不同时间间隔采集右心耳、心包液、肌肉、脂肪和血浆样本，并测定头孢菌素浓度。头孢噻吩和头孢匹林在右心耳、肌肉、脂肪和血浆中的浓度-时间曲线相同。与头孢噻吩相比，头孢匹林在心包液中产生的总浓度和游离浓度更高。这可能是由于头孢匹林的蛋白结合率较低。给药后至少90分钟，心肌组织中的抗生素浓度高于金黄色葡萄球菌和表皮葡萄球菌的最低抑菌浓度。这些数据支持在手术干预前不久使用这些抗生素的必要性，并且如果手术时间延长，则需要给予第二剂抗生素。
