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Войти в исследования The Journal of antimicrobial chemotherapy · 2026
Cefuroxime concentrations in facial artery musculomucosal flap, buccal submucosa, subcutaneous tissue, and plasma following bolus or continuous infusion in patients undergoing oral cancer resection: a randomized clinical microdialysis study.
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Hansen Johanne Ravn, Hillerup Sara, Greibe Eva, Gade Søren, Pikelis Arunas, Hanberg Pelle, Klug Tejs Ehlers
Аннотация
BACKGROUND: Perioperative antibiotic prophylaxis is essential in oral cancer surgery to prevent surgical site infections, particularly when regional flaps such as the facial artery musculomucosal (FAMM) flap are used. This study compared free cefuroxime concentrations in plasma, FAMM flap, buccal submucosa and subcutaneous tissue following bolus infusion (BI) versus continuous infusion (CI).
METHODS: Eighteen patients scheduled for tumour resection and FAMM flap reconstruction were randomized to receive cefuroxime either as BI (1500 mg every 8 h) (Group BI) or CI (4500 mg/day) (Group CI). Microdialysis catheters were placed in the FAMM flap, buccal submucosa and subcutaneous tissue in the neck. Free cefuroxime concentrations were measured over 8 h. The primary endpoints were time with concentrations above the minimal inhibitory concentration (T > MIC) and attainment of the treatment target 50%T > MIC for MIC 2 and 4 mg/L.
RESULTS: All patients achieved ≥50%T > MIC in all tissues for both MIC targets. Group CI achieved 100%T > MIC across all compartments and both MIC thresholds, whereas the mean T > MIC in Group BI were in the range 89%-98% for MIC 2 mg/L and 79%-90% for MIC 4 mg/L. Group CI achieved significantly higher T > MIC than Group BI in subcutaneous tissue for both MIC thresholds and in plasma for MIC 4 mg/L.
CONCLUSIONS: A daily dose of 4500 mg cefuroxime provides adequate tissue and plasma concentrations with both BI and CI to achieve ≥50%T > MIC in patients undergoing oral cavity cancer surgery with FAMM flap reconstruction. CI provided more consistent exposure and may offer pharmacokinetic advantages in selected high-risk situations/patients.
METHODS: Eighteen patients scheduled for tumour resection and FAMM flap reconstruction were randomized to receive cefuroxime either as BI (1500 mg every 8 h) (Group BI) or CI (4500 mg/day) (Group CI). Microdialysis catheters were placed in the FAMM flap, buccal submucosa and subcutaneous tissue in the neck. Free cefuroxime concentrations were measured over 8 h. The primary endpoints were time with concentrations above the minimal inhibitory concentration (T > MIC) and attainment of the treatment target 50%T > MIC for MIC 2 and 4 mg/L.
RESULTS: All patients achieved ≥50%T > MIC in all tissues for both MIC targets. Group CI achieved 100%T > MIC across all compartments and both MIC thresholds, whereas the mean T > MIC in Group BI were in the range 89%-98% for MIC 2 mg/L and 79%-90% for MIC 4 mg/L. Group CI achieved significantly higher T > MIC than Group BI in subcutaneous tissue for both MIC thresholds and in plasma for MIC 4 mg/L.
CONCLUSIONS: A daily dose of 4500 mg cefuroxime provides adequate tissue and plasma concentrations with both BI and CI to achieve ≥50%T > MIC in patients undergoing oral cavity cancer surgery with FAMM flap reconstruction. CI provided more consistent exposure and may offer pharmacokinetic advantages in selected high-risk situations/patients.