Penetration of pefloxacin in human heart valves

Pefloxacin concentrations were measured by HPLC in serum, subcutaneous tissue, heart muscle and heart valves of 41 patients receiving a one hour infusion of 800 mg iv 4, 8, 12, 18, or 24 h before open heart surgery for prosthetic cardiac valve insertion. In all but three of the 46 valvular samples, pefloxacin concentrations were higher than the mode MIC of Staphylococcus, Enterobacteriaceae and Pseudomonas microorganisms causing infections following open heart surgery. Pefloxacin therefore has good penetration of heart valves and is present for up to 24 h. It could be considered as a useful drug in the prophylaxis of cardiac surgery and in therapy of bacterial endocarditis due to susceptible micro-organisms.