Pharmacokinetics of Prophylactic Ampicillin–Sulbactam and Dosing Optimization in Patients Undergoing Cardiovascular Surgery with Cardiopulmonary Bypass
Use this link to cite this item : https://ir.lib.hiroshima-u.ac.jp/00046714
ID | 46714 |
file | |
creator |
Matsumoto, Kazuaki
Watanabe, Erika
Yamamoto, Hiroyuki
Imoto, Yutaka
Takeda, Yasuo
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subject | ampicillin
sulbactam
cardiovascular surgery
prophylaxis
cardiopulmonary bypass
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NDC |
Medical sciences
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abstract | Antibiotic concentrations must be maintained at an adequate level throughout cardiovascular surgery to prevent surgical site infection. This study aimed to determine the most appropriate timing for intraoperative repeated dosing of ampicillin–sulbactam, a commonly used antibiotic prophylaxis regimen, to maintain adequate concentrations throughout the course of cardiovascular surgery with cardiopulmonary bypass (CPB). The total plasma concentrations of ampicillin were monitored in 8 patients after ampicillin (1 g)–sulbactam (0.5 g) administration via initial intravenous infusion and subsequent CPB priming. Pharmacokinetic parameters were estimated and used to predict the free plasma concentrations of ampicillin. The mean values for the volume of distribution, elimination rate constant, elimination half-life, and total clearance of ampicillin were 15.8±4.1 L, 0.505±0.186 h-1, 1.52±0.47 h, and 7.72±2.72 L/h, respectively. When ampicillin (1 g)–sulbactam (0.5 g) was intravenously administered every 3, 4, 6, and 12 h after the start of CPB, the predicted free trough plasma concentrations of ampicillin were 15.20, 8.25, 2.74, and 0.13 μg/mL, respectively. Therefore, an every-6-h regimen was needed to maintain the free ampicillin concentration at more than 2 μg/mL during cardiovascular surgery with CPB. We suggest that the dose and dosing interval for ampicillin–sulbactam should be adjusted to optimize the efficacy and safety of treatment, according to the minimum inhibitory concentrations for methicillin-sensitive Staphylococcus aureus isolates at each institution. Registration number: UMIN000007356.
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journal title |
Biological and Pharmaceutical Bulletin
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volume | Volume 38
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issue | Issue 11
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start page | 1817
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end page | 1821
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date of issued | 2015-11-01
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publisher | The Pharmaceutical Society of Japan
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issn | 0918-6158
1347-5215
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ncid | |
publisher doi | |
naid | |
language |
eng
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nii type |
Journal Article
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HU type |
Journal Articles
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DCMI type | text
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format | application/pdf
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text version | publisher
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rights | Copyright (c) 2015 The Pharmaceutical Society of Japan
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relation url | |
department |
Graduate School of Biomedical & Health Sciences
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