Impact of single dose as compared to three dose prophylaxis with latamoxef (moxalactam) on the colonic microflora in patients undergoing colorectal surgery. 1984

L Kager, and A S Malmborg, and C E Nord, and S Sjöstedt

Twenty patients undergoing colorectal surgery were given an initial dose of 2 g latamoxef (moxalactam) parenterally at the induction of anaesthesia. Ten of the patients received two subsequent doses at 8 h intervals. A series of serum and faecal specimens were taken for analysis of latamoxef concentrations. Tissue samples from intestinal mucosa and peritoneal fat were also taken at surgery. The mean serum peak level was 119.8 +/- 10.7 mg/l. The mean half life was 2.8 h and the mean area under the serum concentration curve was 345.0 +/- 25.7 mg h/l. The concentrations in intestinal mucosa were high when the tissue was removed within 4 h after the administration of latamoxef (22.6 +/- 1.7 micrograms/g, mean +/- S.E.). The concentrations declined when the tissues were removed later (7.8 +/- 0.7 micrograms/g). The content of latamoxef in peritoneal fat varied, range 0.8-23.4, mean 8.5 +/- 1.4 micrograms/g. Measureable levels of latamoxef in faeces were found in all patients except one. The values varied between 0.2 to 23.0, mean 8.9 +/- 1.5 micrograms/g. Faecal samples were also collected during the investigation period for cultivation of aerobic and anaerobic bacteria. The aerobic bacteria-streptococci, enterococci and enterobacteria--were suppressed significantly during the prophylaxis period. Among the anaerobic bacteria--cocci, lactobacilli, bifidobacteria, clostridia, bacteroides and fusobacteria--decreased markedly during the same period. After two weeks the microflora was normalized in all patients. There were no differences between the patients receiving one dose of latamoxef and those receiving three doses. No postoperative infections occurred.

UI MeSH Term Description Entries
D007413 Intestinal Mucosa Lining of the INTESTINES, consisting of an inner EPITHELIUM, a middle LAMINA PROPRIA, and an outer MUSCULARIS MUCOSAE. In the SMALL INTESTINE, the mucosa is characterized by a series of folds and abundance of absorptive cells (ENTEROCYTES) with MICROVILLI. Intestinal Epithelium,Intestinal Glands,Epithelium, Intestinal,Gland, Intestinal,Glands, Intestinal,Intestinal Gland,Mucosa, Intestinal
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009070 Moxalactam Broad- spectrum beta-lactam antibiotic similar in structure to the CEPHALOSPORINS except for the substitution of an oxaazabicyclo moiety for the thiaazabicyclo moiety of certain CEPHALOSPORINS. It has been proposed especially for the meningitides because it passes the blood-brain barrier and for anaerobic infections. 1-Oxacephalosporin,6059-S,Disodium Latamoxef,Disodium Moxalactam,Festamoxin,Lamoxactam,Latamoxef,Lilly 127935,Ly-127935,Ly127935,Moxalactam Disodium,S-6059,Shiomarin,1 Oxacephalosporin,6059 S,6059S,Disodium, Moxalactam,Latamoxef, Disodium,Ly 127935,Moxalactam, Disodium,S 6059,S6059
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
D012007 Rectum The distal segment of the LARGE INTESTINE, between the SIGMOID COLON and the ANAL CANAL. Rectums
D003106 Colon The segment of LARGE INTESTINE between the CECUM and the RECTUM. It includes the ASCENDING COLON; the TRANSVERSE COLON; the DESCENDING COLON; and the SIGMOID COLON. Appendix Epiploica,Taenia Coli,Omental Appendices,Omental Appendix,Appendices, Omental,Appendix, Omental
D005243 Feces Excrement from the INTESTINES, containing unabsorbed solids, waste products, secretions, and BACTERIA of the DIGESTIVE SYSTEM.
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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