cefotaxime and Breast-Neoplasms

Cephalosporin antibiotics have been widely used to prevent infections during and after operation. To establish an efficient use of prophylactic antibiotics for patients undergoing surgery, it is important to investigate the drug levels in exudate from wounds of the patients and to elucidate the relation between drug concentration in the blood and that in the exudate. In a previous paper, the present authors (except E.M. and Y.K.) determined cefotiam (CTM) concentrations in serum and exudate from wounds of patients with breast cancer who underwent radical mastectomy and discussed an adequate regimen of CTM prophylaxis after the operation. However, CTM concentrations in serum and exudate from the wounds of the patients were not analyzed pharmacokinetically. In the present paper we report on the disposition kinetics of CTM in serum and exudate from wounds after the administration of CTM following bolus intravenous injection into patients with breast cancer operated upon for radical mastectomy.

Topics: Adult; Aged; Breast; Breast Neoplasms; Cefotaxime; Cefotiam; Exudates and Transudates; Female; Half-Life; Humans; Injections, Intravenous; Kinetics; Mastectomy; Middle Aged

Cefotiam (CTM) in a dose of 2 g was given by intravenous bolus injection to 16 patients with breast cancer operated upon radical mastectomy with suction drainage. The materials of exudate from drain were taken at intervals by sterilized paper disc and determined by the paper disc method with Proteus mirabilis ATCC 21100 as the test organism to CTM concentrations. CTM concentrations in exudate from suction drain of patients increased quickly after intravenous injection, and reached to peak early time on 2 to 3 days after operation. While on 6 days after operation, the CTM concentrations were comparatively lower and reached to peak at 2 approximately 3 hours after injection. The CTM concentrations in exudate exceed the antibacterial levels of CTM and are thought to be sufficient to produce prophylactic effects in the operation.

Topics: Adult; Aged; Bacterial Infections; Breast; Breast Neoplasms; Cefotaxime; Cefotiam; Exudates and Transudates; Female; Humans; Injections, Intravenous; Kinetics; Mastectomy; Middle Aged; Suction; Surgical Wound Infection

We are reporting on a comparison of serum concentrations of cefotaxime during and after surgery and on its passage to the wound fluid after surgery. Five patients undergoing mastectomy and dissection of the axillary lymph nodes for breast cancer were studied. Serum concentrations were compared after 2 g of cefotaxime dissolved in 20 ml of saline had been administered by i.v. bolus injection intraoperatively during general anaesthesia and six to eight days postoperatively in a conscious state. After intraoperative administration under general anaesthesia, cefotaxime serum concentrations were 157.3 mg/l at 15 min, 87.5 mg/l at 30 min, 43.08 mg/l at 1 h, 15.54 mg/l at 2 h and 9.56 mg/l at 3 h. In a conscious state, cefotaxime serum concentrations were 122.0 mg/l at 15 min, 84.35 mg/l at 30 min, 47.63 mg/l at 1 h, 18.2 mg/l at 2 h and 9.63 mg/l at 3 h, comparable to the time course under general anaesthesia. The half-life of cefotaxime was 0.86 h under general anaesthesia and 0.92 h in a conscious state. Urinary recovery of cefotaxime (0 to 3 h) under anaesthesia and in a conscious state was 53.8% and 56.3%, respectively (as reported previously for a nonsurgical state). Samples of wound fluid were taken at the completion of surgery from the drain inserted subcutaneously into the wound or by means of a tracheal aspirator kit attached to a portable aspirator. Cefotaxime concentrations were determined postoperatively on days six to eight, when the wound fluid became no longer serous.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Anesthesia, General; Breast; Breast Neoplasms; Cefmetazole; Cefoperazone; Cefotaxime; Cefotiam; Ceftizoxime; Ceftriaxone; Cephamycins; Exudates and Transudates; Female; Humans; Mastectomy; Premedication

In order to demonstrate the distribution of an antibiotic to normal breast tissues and its penetration into the axillary wound exudate, 1 g of a new cephem antibiotic, cefotiam (CTM), was infused intravenously over 1 hour in 14 patients with breast cancer before and after mastectomy. CTM concentrations were assayed by the cylinder-plate method, using Proteus mirabilis ATCC 21100 as the test organism. Overall CTM levels in the normal breast tissues ranged from 3.6 to 27.7 micrograms/g, and 5.2 micrograms/g of CTM still remained 170 minutes after administration. No significant differences were found in CTM levels of 3 parts of the breast tissue from the same patient. Serum CTM levels rapidly declined after the end of infusion of CTM. Concentrations of CTM in axillary wound exudate after mastectomy ranged from 5.2 to 13.6 micrograms/ml at 3 hours after administration and were almost undetectable at 24 hours. It is concluded that CTM levels in breast tissues were almost the same as those in other tissues.

Topics: Adult; Aged; Anti-Bacterial Agents; Axilla; Breast; Breast Neoplasms; Cefotaxime; Cefotiam; Exudates and Transudates; Female; Humans; Middle Aged