Abstract
Fifteen children underwent appendectomy following administration of a single i.v. dose of cefoxitin (20 mg/kg). The mean cefoxitin concentration of peritoneal fluid prior to resection of the appendix was 9.3 ± 2.9 μg/ml, representing 264% ± 47% of the concurrent serum concentration. All samples of appendiceal tissue contained less than 5.0 μg/g. Peritoneal cefoxitin levels exceeded the usual minimal inhibitory concentration of Staphylococcus aureus and Escherichia coli, but were indadequate for Bacteroides fragilis. We recommend use of a higher cefoxitin dose (40 mg/kg) for the preoperative prophylaxis of appendectomy in children.
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References
Anhalt JP (1985) Antimicrobial assays. In: Washington JA II (ed) Laboratory procedures in clinical microbiology, 2nd edn. Springer Berlin Heidelberg New York
Darland G, Birnbaum J (1977) Cefoxitin resistance to betalactamase: a major factor for susceptibility of Bacteroides fragilis to the antibiotic. Antimicrob Ag Chemother 11: 725–734
David IB, Buck JR, Filler RM (1982) Rational use of antibiotics for perforated appendicitis in childhood. J Pediatr Surg 17: 494–500
Donovan IA, Ellis D, Gatehouse D (1979) One-dose antibiotic prophylaxis against would infection after appendicectomy: a randomized trial of clindamycin, cefazolin sodium and a placebo. Br J Surg 66: 193–196
Guitierrez C, Vila J, Garcia-Sala C, Velazquez J, Otero M, Santos M, Ruiz-Company S, Gobernado M (1987) Study of appendicitis in children treated with four different antibiotic regimens. J Pediatr Surg 9: 865–868
Wallick H, Hendlin D (1974) Cefoxitin, a semisynthetic cephamycin antibiotic: Susceptibility studies. Antimicrob Ag Chemother 5: 25–32
Wilson RG, Taylor EW, Lindsay G, Dreghorn C, thompson G, McGain J, Bone FJ (1987) A comparative study of cefotetan and metronidazole against metronidazole alone to prevent infection after appendectomy. Surg Gynecol Obstet 164: 447–456
Wise R, Donovan IA, Ambrose NS, Alcock JE (1981) The penetration of cefoxitin into peritoneal fluid. J Antimicrob Chemother 8: 453–457
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Nagar, H., Berger, S.A., Hammar, B. et al. Peritoneal fluid concentrations of cefoxitin in children during appendectomy. Pediatr Surg Int 4, 396–397 (1989). https://doi.org/10.1007/BF00169698
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DOI: https://doi.org/10.1007/BF00169698