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[Serum levels of oxacillin and cephalothin in patients with extracorporeal circulation during surgery].

The authors investigated the oxacillin and cephalotine serum levels in patients operated under conditions of extracorporeal circulation. They found that the time for which the patients are adequately protected against staphylococcal infection is in oxacillin cca 180 mins. and in cephalotine 150 mins. after administration of the first dose of antibiotic. They recommend to administer a second dose of the antibiotic along with protamine sulphate after removal of the aortal cannula to obtain a maximum concentration of the antibiotic in the newly formed blood clots. If the surgical operation lasts longer, they recommend to administer the antibiotic in the given time interval regardless of the operation and to administer a third dose when removing the cannula. The authors investigated a total of 30 patients. In one case they encountered an early and in another case a urinary infection.

Adolescent↗

Antibiotic agranulocytosis: association with cephalothin and carbenicillin.

A 65-year-old woman developed agranulocytosis on two separate occasions following prophylactic administration of antibiotics before cardiac surgery. In the first leukopenic episode, large doses of cephalosporin derivatives were the only drugs implicated, and in the second, carbenicillin was believed responsible. Life-threatening septicemia occurred with Pseduomonas aeruginosa and later with Escherichia coli. Erythrocytes, platelets, and lymphocytes were not affected during these granulocytopenias. Bone marrow examination revealed an arrest of maturation in the granulocytic series. Review of the hematologic complications of cephalosporins, particularly agranulocytosis, suggests an interesting association between carbenicillin-induced neutropenia and previous administration of cephalosporins.

Aged↗