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• W2317735024 abstract "Background: Surgical Site Infection (SSI) prevention for children with congenital heart disease is imperative andmethods to assess and evaluate the tissue concentrations of prophylactic antibiotics are important to help maximizethese efforts. The purpose of this study was to determine the plasma and tissue concentrations of standard-of-careperi-operative cefazolin dosing in an immature porcine model of cardiac surgery and cardiopulmonary bypass.Methods: Piglets (3-5 days old) underwent either median sternotomy (MS) or cardiopulmonary bypass with deephypothermic circulatory arrest (CPB+DHCA) and received standard of care prophylactic cefazolin for theprocedures. Serial plasma and microdialysis sampling of skeletal muscle and subcutaneous tissue adjacent to thesurgical site was performed. Cefazolin concentrations were measured, non-compartmental pharmacokineticanalyses were performed, and tissue penetration of cefazolin was assessed.Results: Following the first intravenous dose, maximal cefazolin concentrations for plasma and tissue sampleswere similar between groups with peak tissue concentrations 15-30 minutes after administration. After the secondcefazolin dose given with initiation of CPB, total plasma cefazolin concentrations remained relatively constant untilthe end of DHCA and then decreased while muscle and subcutaneous unbound cefazolin concentrations showed asecond peak during or after rewarming. For the MS group, 60-67% of the intraoperative time showed tissuecefazolin concentrations greater than16 μg/mL while this percentage was 78-79% for the CPB+DHCA group. Therewas less tissue penetration of cefazolin in the group that underwent CBP+DHCA (P=0.03).Conclusions: The cefazolin dosing used in this study achieves plasma and tissue concentrations that should beeffective against methicillin-sensitive Staphylococcus aureus but may not be effective against some gram-negativepathogens. The timing of cefazolin administration prior to incision and a second dose given during cardiopulmonarybypass may be important factors for achieving goal tissue concentrations." @default.
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• W2317735024 date "2015-01-01" @default.
• W2317735024 modified "2023-09-27" @default.
• W2317735024 title "Plasma and Tissue Pharmacokinetics of Cefazolin in an Immature Porcine Model of Pediatric Cardiac Surgery" @default.
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• W2317735024 doi "https://doi.org/10.4172/2155-6148.1000508" @default.
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