The Annals New | Pharmaco Epidemiology and Therapeutic Risk Management
home help contact us subscription past issues search current issue
QUICK SEARCH:   [advanced]


     

Drug Intelligence & Clinical Pharmacy: Vol. 20, No. 11, pp. 869-873.
© 1986 Harvey Whitney Books Company.
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow Articles Ahead of Print
Right arrow [Order Reprint]
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Mann, H.
Right arrow Articles by Buchwald, H
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Mann, H.
Right arrow Articles by Buchwald, H

Research Articles

Cefamandole distribution in serum, adipose tissue, and wound drainage in morbidly obese patients

HJ Mann and H Buchwald

Distribution and elimination of cefamandole 2 g iv were studied in 11 morbidly obese patients during a gastric bypass operation and again on the first postoperative day. Serum, subcutaneous adipose tissue, wound drainage, and urine were analyzed by high performance liquid chromatography for cefamandole and pharmacokinetic parameters from the intraoperative period were compared to those obtained postoperatively. Total body clearance was significantly greater (p less than 0.001) postoperatively (297 ml/min) than intraoperatively (254 ml/min). Volume changes were unpredictable but the elimination rate constant tended to increase postoperatively. Renal clearance and percentage of urinary recovery were significantly increased (p less than 0.01) postoperatively. The patients had a mean (+/- SD) volume of the central compartment of 10.3 (+/- 2.3) L, volume at steady state of 18.3 (+/- 3.9) L, and elimination rate constant of 1.67 (+/- 0.63) h-1. Tissue concentrations of cefamandole were highest during the first hour after drug administration and were less than 1 microgram/g after 3.5 hours. Mean wound drainage concentrations ranged between 10 and 12 micrograms/ml during a dosing interval and dropped to 7 micrograms/ml 12 hours after the last dose. Intraoperative dosing of cefamandole is required to maintain subcutaneous adipose tissue concentrations greater than 1 microgram/g during procedures longer than three hours in morbidly obese patients. A postoperative dose of cefamandole 2 g iv q6h will provide sustained and therapeutic concentrations in the wound drainage of morbidly obese patients.


This article has been cited by other articles:


Home page
 Antimicrob. Agents Chemother.Home page
M. Chen, A. N. Nafziger, G. L. Drusano, L. Ma, and J. S. Bertino Jr.
Comparative pharmacokinetics and pharmacodynamic target attainment of ertapenem in normal-weight, obese, and extremely obese adults.
Antimicrob. Agents Chemother., April 1, 2006; 50(4): 1222 - 1227.
[Abstract] [Full Text] [PDF]


homecopy help contact us subscription past issues search current issue
Copyright © 1986 by Harvey Whitney Books Company.