The Annals of Thoracic Surgery, Vol 31, 155-160, Copyright © 1981 by The Society of Thoracic Surgeons
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
ER Green, S Subramanian, H Faden, R Quintiliani and CH Nightingale
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.
