Publication

Blood concentrations of cefuroxime in cardiopulmonary bypass surgery

Bertholee, D., ter Horst, P. G. J., Hijmering, M. L., Spanjersberg, A. J., Hospes, W. & Wilffert, B., Oct-2013, In : International Journal of Clinical Pharmacy. 35, 5, p. 798-804 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

APA

Bertholee, D., ter Horst, P. G. J., Hijmering, M. L., Spanjersberg, A. J., Hospes, W., & Wilffert, B. (2013). Blood concentrations of cefuroxime in cardiopulmonary bypass surgery. International Journal of Clinical Pharmacy, 35(5), 798-804. https://doi.org/10.1007/s11096-013-9810-z

Author

Bertholee, Daphne ; ter Horst, Peter G. J. ; Hijmering, Michel L. ; Spanjersberg, Alexander J. ; Hospes, Wobbe ; Wilffert, Bob. / Blood concentrations of cefuroxime in cardiopulmonary bypass surgery. In: International Journal of Clinical Pharmacy. 2013 ; Vol. 35, No. 5. pp. 798-804.

Harvard

Bertholee, D, ter Horst, PGJ, Hijmering, ML, Spanjersberg, AJ, Hospes, W & Wilffert, B 2013, 'Blood concentrations of cefuroxime in cardiopulmonary bypass surgery', International Journal of Clinical Pharmacy, vol. 35, no. 5, pp. 798-804. https://doi.org/10.1007/s11096-013-9810-z

Standard

Blood concentrations of cefuroxime in cardiopulmonary bypass surgery. / Bertholee, Daphne; ter Horst, Peter G. J.; Hijmering, Michel L.; Spanjersberg, Alexander J.; Hospes, Wobbe; Wilffert, Bob.

In: International Journal of Clinical Pharmacy, Vol. 35, No. 5, 10.2013, p. 798-804.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Bertholee D, ter Horst PGJ, Hijmering ML, Spanjersberg AJ, Hospes W, Wilffert B. Blood concentrations of cefuroxime in cardiopulmonary bypass surgery. International Journal of Clinical Pharmacy. 2013 Oct;35(5):798-804. https://doi.org/10.1007/s11096-013-9810-z


BibTeX

@article{da88a8618fee4462a3ac61cf83518624,
title = "Blood concentrations of cefuroxime in cardiopulmonary bypass surgery",
abstract = "Objectives Patients with coronary artery bypass graft (CABG) surgery are at risk for severe postoperative infections. Prophylactic cefuroxime may help to reduce this risk, however sufficient concentrations, i.e. above the breakpoint (32 mg/L), are mandatory. The aim of this study is to evaluate the blood concentrations of cefuroxime during and after CABG surgery with cardiopulmonary bypass (CPB) and hypothermia, to determine the concentration of cefuroxime in sternum fluid and to evaluate possible factors of influence. Methods Seventeen patients were enrolled in this study, given 1.5 g cefuroxime at anaesthesia induction and an additional 1.5 g at start CPB. Blood samples were collected at skin incision, start CPB, every 30 min on CPB, end CPB, at wound closure and 1 h after surgery. Cefuroxime concentrations were determined by high performance liquid chromatography. Results In 47 {\%} of the patients the cefuroxime concentration was below the breakpoint at some point during the operation and in 59 {\%} of the patients 1 h after surgery. A statistically significant inverse correlation between estimated glomerular filtration rate and plasma cefuroxime concentrations was found (P = 0.034). Cefuroxime levels in the sternum are not significantly different from blood levels from the radial artery catheter, taken at approximately the same time (P = 0.30). Conclusions The current antibiotic regimen used did not maintain cefuroxime concentrations above the breakpoint throughout the operation, suggesting insufficient antibiotic prophylaxis. Further research to other antibiotic regimes is therefore necessary.",
keywords = "Antibiotic prophylaxis, Cardiopulmonary bypass, Cefuroxime, Coronary artery bypass graft surgery, Pharmacokinetics, INFECTION PREVENTION PROJECT, CARDIAC-SURGERY, ANTIMICROBIAL PROPHYLAXIS, PLASMA-CONCENTRATIONS, CONTINUOUS-INFUSION, ADVISORY STATEMENT, PHARMACOKINETICS, TISSUE, MICRODIALYSIS, ANTIBIOTICS",
author = "Daphne Bertholee and {ter Horst}, {Peter G. J.} and Hijmering, {Michel L.} and Spanjersberg, {Alexander J.} and Wobbe Hospes and Bob Wilffert",
year = "2013",
month = "10",
doi = "10.1007/s11096-013-9810-z",
language = "English",
volume = "35",
pages = "798--804",
journal = "International Journal of Clinical Pharmacy",
issn = "2210-7703",
publisher = "SPRINGER",
number = "5",

}

RIS

TY - JOUR

T1 - Blood concentrations of cefuroxime in cardiopulmonary bypass surgery

AU - Bertholee, Daphne

AU - ter Horst, Peter G. J.

AU - Hijmering, Michel L.

AU - Spanjersberg, Alexander J.

AU - Hospes, Wobbe

AU - Wilffert, Bob

PY - 2013/10

Y1 - 2013/10

N2 - Objectives Patients with coronary artery bypass graft (CABG) surgery are at risk for severe postoperative infections. Prophylactic cefuroxime may help to reduce this risk, however sufficient concentrations, i.e. above the breakpoint (32 mg/L), are mandatory. The aim of this study is to evaluate the blood concentrations of cefuroxime during and after CABG surgery with cardiopulmonary bypass (CPB) and hypothermia, to determine the concentration of cefuroxime in sternum fluid and to evaluate possible factors of influence. Methods Seventeen patients were enrolled in this study, given 1.5 g cefuroxime at anaesthesia induction and an additional 1.5 g at start CPB. Blood samples were collected at skin incision, start CPB, every 30 min on CPB, end CPB, at wound closure and 1 h after surgery. Cefuroxime concentrations were determined by high performance liquid chromatography. Results In 47 % of the patients the cefuroxime concentration was below the breakpoint at some point during the operation and in 59 % of the patients 1 h after surgery. A statistically significant inverse correlation between estimated glomerular filtration rate and plasma cefuroxime concentrations was found (P = 0.034). Cefuroxime levels in the sternum are not significantly different from blood levels from the radial artery catheter, taken at approximately the same time (P = 0.30). Conclusions The current antibiotic regimen used did not maintain cefuroxime concentrations above the breakpoint throughout the operation, suggesting insufficient antibiotic prophylaxis. Further research to other antibiotic regimes is therefore necessary.

AB - Objectives Patients with coronary artery bypass graft (CABG) surgery are at risk for severe postoperative infections. Prophylactic cefuroxime may help to reduce this risk, however sufficient concentrations, i.e. above the breakpoint (32 mg/L), are mandatory. The aim of this study is to evaluate the blood concentrations of cefuroxime during and after CABG surgery with cardiopulmonary bypass (CPB) and hypothermia, to determine the concentration of cefuroxime in sternum fluid and to evaluate possible factors of influence. Methods Seventeen patients were enrolled in this study, given 1.5 g cefuroxime at anaesthesia induction and an additional 1.5 g at start CPB. Blood samples were collected at skin incision, start CPB, every 30 min on CPB, end CPB, at wound closure and 1 h after surgery. Cefuroxime concentrations were determined by high performance liquid chromatography. Results In 47 % of the patients the cefuroxime concentration was below the breakpoint at some point during the operation and in 59 % of the patients 1 h after surgery. A statistically significant inverse correlation between estimated glomerular filtration rate and plasma cefuroxime concentrations was found (P = 0.034). Cefuroxime levels in the sternum are not significantly different from blood levels from the radial artery catheter, taken at approximately the same time (P = 0.30). Conclusions The current antibiotic regimen used did not maintain cefuroxime concentrations above the breakpoint throughout the operation, suggesting insufficient antibiotic prophylaxis. Further research to other antibiotic regimes is therefore necessary.

KW - Antibiotic prophylaxis

KW - Cardiopulmonary bypass

KW - Cefuroxime

KW - Coronary artery bypass graft surgery

KW - Pharmacokinetics

KW - INFECTION PREVENTION PROJECT

KW - CARDIAC-SURGERY

KW - ANTIMICROBIAL PROPHYLAXIS

KW - PLASMA-CONCENTRATIONS

KW - CONTINUOUS-INFUSION

KW - ADVISORY STATEMENT

KW - PHARMACOKINETICS

KW - TISSUE

KW - MICRODIALYSIS

KW - ANTIBIOTICS

U2 - 10.1007/s11096-013-9810-z

DO - 10.1007/s11096-013-9810-z

M3 - Article

VL - 35

SP - 798

EP - 804

JO - International Journal of Clinical Pharmacy

JF - International Journal of Clinical Pharmacy

SN - 2210-7703

IS - 5

ER -

ID: 5972362