Concentration of cephalosporins in tissues of the head and neck after parenteral infusion.

Cephalosporins are successfully used in the therapy of acute sinusitis, purulent parotitis, and lymphadenitis. Anti-infectious prophylaxis in major head and neck surgery may be performed with cephalosporins as first choice. For sufficient prophylaxis or therapy, an effective level of the antibiotic drug in the serum and tissue of the target organs is necessary. In a comparative investigation, we measured serum and tissue levels of three regions of the head and neck (parotid glands, paranasal sinuses, soft tissue of the neck) of the second-generation cephalosporins, cefuroxime and cefotiam, after a single parenteral infusion. Both antibiotics reach levels which are effective against bacteria typically causing spontaneous or postoperative infection of head and neck tissue. Effective levels of cefuroxime both at the investigated tissue sites and in serum are greater than those of cefotiam, and cefuroxime is eliminated from serum less rapidly. The pharmacologic data show that both drugs are suitable for therapy and perioperative prophylaxis of purulent head and neck infections, but various data indicate that there is an advantage in favor of cefuroxime.