Biliary excretion and tissue levels of cefuroxime

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Abstract
A study of levels of cefuroxime in blood, liver, gall bladder wall, gall bladder bile, bile from the common bile duct, muscle and skin of patients undergoing cholecystectomy after a single intravenous dose of 750 mg of cefuroxime sodium given at the time of induction of anaesthesia is reported. Levels in bile varied widely and were generally low in samples from diseased gall bladders (mean 4.8 mg/l) but higher levels (mean 9.0 mg/l) were detected in samples from the unobstructed common bile duct. Tissue levels were lower than blood levels, but those in muscle and skin (mean 9.4 mg/kg) would be sufficient to exert a useful antibacterial effect. It is suggested that blood and tissue levels may be more important than bile levels in the prophylaxis of post-operative wound infection, but this and the use of preoperative single dose antibiotic prophylaxis in surgery deserves further study.

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