Pharmacokinetics of three-dose cefoxitin prophylaxis in caesarean section. 1988

A J Roex, and A C Van Loenen
Department of Obstetrics and Gynaecology, Medisch Centrum Alkmaar, The Netherlands.

A pharmacokinetic analysis of cefoxitin in women undergoing caesarean section under general anaesthesia, was performed. In order to prevent infections postoperatively three doses of cefoxitin--2, 1 and 1 g, respectively--were given as a 3-min intravenous infusion at 6-h intervals. In vitro growth of most pathogens is inhibited at a cefoxitin concentration of 16 micrograms/ml. In the sera of the patients, this antibiotic level was maintained for a period of 90-100 min after the first administration (2 g) and 45-50 min after the second and the third administration of cefoxitin (1 g). The period of subinhibitory antibiotic concentrations lasted 270 and 315 min, respectively. How can one reach prolonged antibiotic coverage? In order to minimize antibiotic pressure on hospital flora it is advisable not to increase the total amount of antibiotic (4 g) administered. By starting a 310 mg/h infusion after the initial 2 g bolus injection, the serum concentration of cefoxitin can be maintained at a minimum level of 16 micrograms/ml during a period of 6.5 h. The improvement of antibiotic administration suggested requires further clinical testing.

UI MeSH Term Description Entries
D008657 Metabolic Clearance Rate Volume of biological fluid completely cleared of drug metabolites as measured in unit time. Elimination occurs as a result of metabolic processes in the kidney, liver, saliva, sweat, intestine, heart, brain, or other site. Total Body Clearance Rate,Clearance Rate, Metabolic,Clearance Rates, Metabolic,Metabolic Clearance Rates,Rate, Metabolic Clearance,Rates, Metabolic Clearance
D011247 Pregnancy The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH. Gestation,Pregnancies
D011292 Premedication Preliminary administration of a drug preceding a diagnostic, therapeutic, or surgical procedure. The commonest types of premedication are antibiotics (ANTIBIOTIC PROPHYLAXIS) and anti-anxiety agents. It does not include PREANESTHETIC MEDICATION. Premedications
D002440 Cefoxitin A semisynthetic cephamycin antibiotic resistant to beta-lactamase. Cefoxitin Sodium,MK-306,Mefoxin,Mefoxitin,Méfoxin,MK 306,MK306,Sodium, Cefoxitin
D002585 Cesarean Section Extraction of the FETUS by means of abdominal HYSTEROTOMY. Abdominal Delivery,Delivery, Abdominal,C-Section (OB),Caesarean Section,Postcesarean Section,Abdominal Deliveries,C Section (OB),C-Sections (OB),Caesarean Sections,Cesarean Sections,Deliveries, Abdominal
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013530 Surgical Wound Infection Infection occurring at the site of a surgical incision. Postoperative Wound Infection,Infection, Postoperative Wound,Infection, Surgical Wound,Surgical Site Infection,Wound Infection, Postoperative,Wound Infection, Surgical,Infection, Surgical Site,Infections, Postoperative Wound,Infections, Surgical Site,Infections, Surgical Wound,Postoperative Wound Infections,Surgical Site Infections,Surgical Wound Infections,Wound Infections, Postoperative,Wound Infections, Surgical

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