Avaliação das concentrações plasmáticas e da farmacocinética da cefuroxima administrada profilaticamente em pacientes submetidos à revascularização do miocárdio / Plasma levels and pharmacokinetics of cefuroxime administered prophylactically for patients undergoing coronary surgery

AUTOR(ES)

Fabiana Aparecida Penachi Bosco Ferreira

FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

16/08/2011

RESUMO

Background and Objectives: Cardiopulmonary bypass (CPB) can alter the kinetic of drugs, including antibiotics. The aim of this study was evaluation of the CPB influence on the plasma concentrations and pharmacokinetics of cefuroxime and assess whether the dosing regimen 1.5 g dose, followed by 750 mg 6/6h for 24h is adequate for antibiotic prophylaxis. Methods: A prospective controlled observational study compared 10 patients undergoing surgery with CPB and 9 submitted to off-pump surgery, (Clinical trials identifier: NCT0122882). After each cefuroxime dose, blood samples were sequentially collected and analyzed using high-efficiency chromatography (HPLC). Plasma concentrations were compared using variance analysis and log-rank test was employed to evaluate the differences between curves that quantified the fraction of patients with a remaining plasma concentration above 16 mg/L within 6 h after each bolus; considering P <0.05 significant. Results: After each cefuroxime bolus, both groups presented a significant decrease in plasma concentration over time (p<0.001). Mean CPB time of 59.7 ± 21.1 min did not change cefuroxime pharmacokinetics or plasma concentrations. The mean clearance ± SD (mL/kg/min) and median of minimum concentration (mg/dL) of the CPB group versus the off-pump group were 1.7 ± 0.7 versus 1.6 ± 0.6 (p= 0.67) and 6.1 versus 5.7 (p= 0.77), respectively. Up to 3 h, but not after 6 h, following the first bolus, all patients had plasma concentrations above 16 mg/L (CPB group= 0.2 and off-pump group= 0.44, p=0.867). After another bolus, concentrations below 16 mg/dL were reached before 3 h. Conclusions: CPB does not influence cefuroxime plasma concentration, but pharmacokinetic data should be considered when choosing intervals between doses

ASSUNTO(S)

antibioticoprofilaxia cardiac surgery cardiopulmonary bypass cefuroxima cefuroxime circulação extracorpórea cirurgia cardíaca farmacocinética hplc hplc pharmacokinetics prophylaxis

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