Penetration of third-generation cephalosporins into human peritoneal tissue

Each of 40 patients underwent elective laparotomy following administration of a single 1.0-gram intravenous dose of ceftizoxime, ceftriaxone, cefoperazone or cefotaxime. Therapeutic concentrations of cefoperazone and ceftriaxone were achieved in peritoneal tissue in 20/20 patients. Only 9/20 samples from patients receiving the other two antibiotics had detectable antibiotic activity. The antibiotic concentration in peritoneal fluid (7 samples) was 2.36-11.15 times higher than that of concurrently obtained peritoneal tissue. When adjusted for the in vitro susceptibility (MIC) of potential peritoneal pathogens, our data suggest that ceftriaxone and cefoperazone may be preferable to other third-generation cephalosporins for the prophylaxis and therapy of intraabdominal infection.