Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2023, 167(2):208-211 | DOI: 10.5507/bp.2022.033

Population pharmacokinetics of three alternative prophylactic antibiotics during cardiac surgery with extracorporeal circulation

Petr Santavy1, Vendula Kubickova2, Martin Sima3, Karel Urbanek2
1 Department of Cardiac Surgery, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
2 Department of Pharmacology, Faculty of Medicine and Dentistry, Palacky University Olomouc and University Hospital Olomouc, Czech Republic
3 Department of Pharmacology, First Faculty of Medicine, Charles University in Prague and General University Hospital, Prague, Czech Republic

Aims: The aim of this pharmacokinetic study was to describe and quantify population pharmacokinetics of three antibiotics, cefazolin, ampicillin, and ciprofloxacin, used as antibacterial prophylaxis during cardiovascular surgery with the use of extracorporeal circulation (ECC).

Methods: Adult patients undergoing cardiac surgery with ECC were enrolled to this prospective, pharmacokinetic study. An intravenous bolus of 2 g of ampicillin, 2 g of cefazolin or 400 mg of ciprofloxacin was administered 60-30 min before surgery. Blood samples were collected at 15, 30, 45, 60, 120 and 180 min after the administration and at the end of the surgery. Plasma concentrations of the antibiotics were measured using HPLC methods. Serum concentration-time profiles were analyzed using nonlinear mixed-effects modeling approach.

Results: A total of 54 patients were enrolled into the study, 20 with ampicillin, 25 cefazolin and 9 ciprofloxacin. For all antibiotics, population pharmacokinetic models have been successfully developed.

Conclusion: We identified estimated glomerular filtration rate (eGFR) as the main factor determining the achievement of the pharmacokinetic/pharmacodynamic (PK/PD) target in ampicillin or cefazolin and body weight in ciprofloxacin prophylaxis during cardiac surgery with ECC support.

Keywords: population pharmacokinetics, cardiac surgery, extracorporeal circulation, ampicillin, cefazolin, ciprofloxacin

Received: June 20, 2022; Revised: June 24, 2022; Accepted: June 27, 2022; Prepublished online: June 29, 2022; Published: June 12, 2023  Show citation

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Santavy, P., Kubickova, V., Sima, M., & Urbanek, K. (2023). Population pharmacokinetics of three alternative prophylactic antibiotics during cardiac surgery with extracorporeal circulation. Biomedical papers, 167(2), 208-211. doi: 10.5507/bp.2022.033
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