Journal of Antimicrobial Chemotherapy (2000) 45, 243-245
© 2000 The British Society for Antimicrobial Chemotherapy
Brief reports |
Pharmacokinetics and tissue penetration of vancomycin in patients undergoing prosthetic mammary surgery
a Department of Immunology and Infectious Diseases, and b Department of Plastic and Reconstructive Surgery, Università ed Azienda Ospedaliera di Verona, Verona; c B.T. Biotecnica, Varese, Italy
Vancomycin concentrations in periprosthetic breast tissues were evaluated in 24 women undergoing reconstructive surgery after mastectomy for breast cancer. Patients were given a single prophylactic dose of vancomycin (1 g iv) 1–8 h before surgery, and mean capsular and pericapsular tissue concentrations were measured by HPLC. Vancomycin was not detectable in the majority of patients belonging to the 1–3 h post-dose groups, whereas in the 4–8 h post-dose groups, mean capsular and pericapsular concentrations were as follows: at 4 h, 4.0 mg/kg and 5.9 mg/kg; at 6 h, 4.1 mg/kg and 4.8 mg/kg; at 8 h, 5.9 mg/kg and 11.1 mg/kg, respectively. Vancomycin tissue concentrations thus were equal to or exceeded the breakpoint of 4 mg/L in most samples collected 4–8 h after dosing. In conclusion, our data suggest that appropriate timing of vancomycin prophylaxis should be considered to allow the maintenance of adequate tissue concentrations throughout the surgical procedure.
* Correspondence address. Divisione Clinicizzata di Malattie Infettive, Ospedale Civile Maggiore, Piazzale Stefani 1, 37126 Verona, Italy. Tel: +39-045-8073295; Fax: +39-045-8340223; E-mail: luzzati{at}borgotrento.univr.it