BACKGROUND: Preincisional intraparietal injection of antibiotics is used for the prophylaxis of postoperative surgical infections. Whether topically injected antibiotics remain primarily in the surgical wound or are systematically absorbed is uncertain, however. PATIENTS AND METHODS: The pharmacokinetics of preincisional injection of 2 g ceftriaxone were studied in 20 patients who have undergone abdominal surgery, with determination of serum, wound tissue, and wound fluid antibiotic concentrations. RESULTS: Preincisional injection of ceftriaxone resulted in high antibiotic concentrations in the wound tissue and wound fluid. The highest plasma concentrations were achieved at 1.50 hours (99.47 +/- 14.67 micrograms/mL). Plasma concentrations exceeded the minimal inhibitory concentrations of most aerobic gram-positive and gram-negative organisms with the exception of Pseudomonas aeruginosa, Acinetobacter species, and Streptococcus faecalis for 24 hours (10.42 +/- 4.12). No local or general complications arose in any of the patients. CONCLUSIONS: Our results suggest that preincisional administration of ceftriaxone for prophylaxis is very effective.
BACKGROUND: Preincisional intraparietal injection of antibiotics is used for the prophylaxis of postoperative surgical infections. Whether topically injected antibiotics remain primarily in the surgical wound or are systematically absorbed is uncertain, however. PATIENTS AND METHODS: The pharmacokinetics of preincisional injection of 2 g ceftriaxone were studied in 20 patients who have undergone abdominal surgery, with determination of serum, wound tissue, and wound fluid antibiotic concentrations. RESULTS: Preincisional injection of ceftriaxone resulted in high antibiotic concentrations in the wound tissue and wound fluid. The highest plasma concentrations were achieved at 1.50 hours (99.47 +/- 14.67 micrograms/mL). Plasma concentrations exceeded the minimal inhibitory concentrations of most aerobic gram-positive and gram-negative organisms with the exception of Pseudomonas aeruginosa, Acinetobacter species, and Streptococcus faecalis for 24 hours (10.42 +/- 4.12). No local or general complications arose in any of the patients. CONCLUSIONS: Our results suggest that preincisional administration of ceftriaxone for prophylaxis is very effective.