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J Cardiothorac Vasc Anesth. 2003 Apr;17(2):221-5.

Antibiotic prophylaxis with cefazolin and gentamicin in cardiac surgery for children less than ten kilograms.

Author information

1
Service d'Anesthésie-Réanimation and Equipe d'Accueil 1896, Hôpital Cardiovasculaire et Pneumologique Louis Pradel, Lyon, France.

Abstract

OBJECTIVE:

Antibiotic prophylaxis is recommended in pediatric cardiac surgery, but no data concerning the current antibiotic regimen were available.

DESIGN:

Prospective study from April to June 2000.

SETTING:

University hospital operating room and postoperative intensive care unit.

PARTICIPANTS:

Nineteen consecutive infants less than 10 kg with normal renal function undergoing cardiac surgery with cardiopulmonary bypass longer than 30 minutes.

INTERVENTIONS:

Intravenous administration of cefazolin, 40 mg/kg, and gentamicin, 5 mg/kg, at induction of anesthesia; followed by cefazolin, 35 mg/kg every 8 hours, and gentamicin, 2 mg/kg every 12 hours, over 48 hours.

MEASUREMENTS AND MAIN RESULTS:

Levels of serum antibiotics were measured: cefazolin (microbiologic) and gentamicin (fluorescence immunoassay) with 8 intraoperative and 5 postoperative samplings. Intraoperatively, cefazolin levels decreased from 166 +/- 44 (mean +/- standard deviation) down to 54 +/- 16 microg/mL and gentamicin from 20.8 +/- 9.5 down to 5.9 +/- 1.5 microg/mL. The postoperative trough levels were 12 +/- 7, 15 +/- 10, and 19 +/- 22 microg/mL for cefazolin and 1.1 +/- 0.5, 0.8 +/- 0.4, and 0.8 +/- 0.9 microg/mL for gentamicin.

CONCLUSIONS:

Antibiotic serum levels are consistent with satisfactory efficacy, but intraoperative gentamicin peak levels appeared too high.

PMID:
12698406
DOI:
10.1053/jcan.2003.51
[Indexed for MEDLINE]

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