Intravenous cefuroxime prophylaxis Tissue levels after one 3-gram dose in 40 cases of hip fracture

Abstract

This study consists of 2 series of patients with cervical hip fracture treated with hemiarthroplasty. In a preliminary study, the method, timing of sample collection, and tissue and serum concentrations were studied in 15 patients. In the main study of another 25 patients, only tissue samples were collected.

In the preliminary study, 3 g of cefuroxime was infused in 15-25 min and serum, muscle, fascia and bone samples were collected at various times. In the main study, 1 dose of 3 g of cefuroxime was infused in 15 min. Skin, muscle, fascia, and bone tissue samples were collected after 30 and 45 min and the concentrations of cefuroxime were measured by high-performance liquid chromatography. In the preliminary study, serum cefuroxime levels were 61 μg/mL and 42 μg/mL at 15-30 and 35-50 min, respectively. Cefuroxime levels in various tissues were only slightly less than those in serum. Blood contamination contributed less than 30 percent to the tissue levels of cefuroxime.

In the main study, mean cefuroxime levels in the tissues were in the range of 39-58 μg/g, and the total range was 5.5-151 μg/g at 30 and 45 min. These concentrations are well above the MIC values of the most common bacteria causing wound and bone infections.