Perioperative pharmacokinetics of ceftriaxone in caesarean section

Background. Evaluation of the antibiotic serum and tissue concentrations in the area of surgical intervention is necessary for determination the most rational antibiotic dosing regimen for perioperative prophylaxis. Objective. Determination of serum concentrations and the degree of penetration of ceftriaxone into the myometrium with antibiotic prophylaxis during cesarean section to select a rational dosage regimen. Methods. A total of 14 pregnant women delivered by planned cesarean section were examined. For the perioperative antibiotic prophylaxis, ceftriaxone was administered intravenously in various dosage regimens. The quantitative content of ceftriaxone during cesarean section was studied using chromatographic and spectrophotometric methods. Results. Stable serum ceftriaxone concentrations were maintained in all studied groups during the perioperative period. The level of ceftriaxone accumulation in the myometrium exceeded the “critical" level for the most significant pathogens. Conclusion. With normal body mass index values, a dosage of ceftriaxone of 1.0 g provides pregnant women with adequate antimicrobial protection throughout the entire abdominal delivery and in the first hours of the postoperative period. Increasing the dosage of ceftriaxone to 2.0 g does not provide pharmacokinetic benefits.

antibiotic prophylaxis, cesarean section, ceftriaxone, pharmacokinetics, penetration into the myometrium