cefotaxime and Uterine-Neoplasms

Infections represents 5% of our post-operative morbidity and result in the use of expensive antibiotics and longer hospital stays. As a less expensive alternative to systematic antibiotherapy for all patients, the authors propose a prospective and descriptive study of the effectiveness of antibioprophylaxis by administering 1 g of Cefotaxime pre-operatively. The study concerns a continuous series of 103 cases in gynaecology and obstetrics operated in the Dakar University Teaching Hospital, during a 13 months period (April 95-April 96). The average age of the patients is 30 years, the major types of surgery was cesarean sections, laparotomy for extra-uterine pregnancy and myomectomies. The duration of the surgery varied between 40 to 105 minutes with an average of 60 minutes. There was no intolerance to Cefotaxime. No cases of post operative infections were observed. All surgical wounds healed in 6 to 8 days except 2 minor cases of non-union of 1 cm. Antibioprophylaxis with Cefotaxime can therefore be considered as an effective means of preventing post-operative infections in clean surgery. It is easy to administer and also has the advantage of lower cost (4050 Fcfa compared to 29,000 Fcfa for classic antibiotherapy).

Topics: Adolescent; Adult; Antibiotic Prophylaxis; Cefotaxime; Cesarean Section; Female; Gynecologic Surgical Procedures; Humans; Hygiene; Hysterectomy; Leiomyoma; Ovarian Cysts; Preanesthetic Medication; Pregnancy; Pregnancy, Tubal; Senegal; Skin; Surgical Wound Infection; Uterine Neoplasms

We have conducted pharmacokinetic and clinical trials of a new cephem derivative, cefodizime (THR-221, CDZM), and obtained the following results. 1. We administered CDZM to 4 cases with abdominal simple hysterectomy due to myoma uteri at a dose level of 1 g by drip intravenous injection and studied average levels of transfer measured at various locations in the uterine tissues and adnexa at an average of 2 hours after administration. CDZM level was highest in the oviduct, 13.7 micrograms/g (ratio with respect to the uterine arterial blood: 91.3%), followed by the ovary, portio vaginalis, cervix uteri and endometrium, and was lowest in the myometrium, 8.3 micrograms/g (55.3%). CDZM concentrations were higher than 6.04 micrograms/g in any tissues. 2. To study CDZM transfer to pelvic cavity fluid, we administered CDZM to 5 cases with total hysterectomy due to cervical cancer of uteri at a dose level of 2 g using drip intravenous injection. The drug was transferred at high levels to the pelvic cavity fluid. A level of 11.7 micrograms/ml was observed at 3 hours after injection. The drug levels in the pelvic cavity fluid were maintained continuously higher levels than those of venous blood. These concentrations in the uterine tissues and pelvic cavity fluid were higher than the MIC against many strains of Gram-positive and Gram-negative bacteria, hence we considered them to be therapeutically effective concentrations. 3. Eleven cases of gynecological infections receiving in totals of 8 to 48 g of CDZM demonstrated "excellent" results in 3 cases, "good" in 8 cases. Eight strains of organisms were isolated from 10 cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adult; Aged; Aged, 80 and over; Bacterial Infections; Cefotaxime; Drug Evaluation; Female; Genital Diseases, Female; Genitalia, Female; Humans; Hysterectomy; Infusions, Intravenous; Leiomyoma; Middle Aged; Postoperative Period; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: Abdominal Muscles; Amikacin; Bacillus; Cefotaxime; Clindamycin; Drug Therapy, Combination; Escherichia coli; Female; Humans; Hysterectomy; Leiomyoma; Metronidazole; Middle Aged; Necrosis; Penicillin G; Peptostreptococcus; Surgical Wound Infection; Uterine Neoplasms

This study was to investigate the transfer of cefmenoxime (CMX) to the retroperitoneal fluid after extensive panhysterectomy. Twenty-two cases were examined and they were divided into 2 groups, 10 with 1.0 g and 12 with 2.0 g bolus intravenous administration of CMX. In 1.0 g group, CMX concentration in the retroperitoneal fluid was observed 42.0 +/- 9.59 micrograms/ml (Mean +/- S.D.) at 1 hour and thereafter decreased gradually, but it still remained 7.91 +/- 5.18 micrograms/ml at 6 hours after the administration. In 2.0 g group, its concentration was 33.4 +/- 34.5 micrograms/ml at 30 minutes and reached to the peak level of 45.1 +/- 24.6 micrograms/ml at 1 hour and then declined slowly, but it remained 13.3 +/- 8.28 micrograms/ml at 6 hours after the injection. The results demonstrated sufficient transfer of CMX to the retroperitoneal fluid.

Topics: Adult; Aged; Body Fluids; Cefmenoxime; Cefotaxime; Female; Humans; Hysterectomy; Injections, Intravenous; Middle Aged; Postoperative Period; Retroperitoneal Space; Uterine Neoplasms

Ceftriaxone (Ro 13-9904, CTRX) was studied about the tissue transfer in the gyneco-obstetric field and the following results were obtained. The transfer of CTRX into the uterine tissues and adnexa was favorable following an intravenous injection with 1 g. The mean serum level 1 hour after administration was 123.3 micrograms/ml while the tissue level ranged from 26 to 48 micrograms/g. The level in the pelvic dead space exudate reached a peak 3 to 6 hours after administration and got higher than the serum level at 5 to 6 hours.

Topics: Cefotaxime; Ceftriaxone; Exudates and Transudates; Female; Genitalia, Female; Humans; Injections, Intravenous; Pelvis; Tissue Distribution; Uterine Cervical Neoplasms; Uterine Neoplasms