[Clinical study of diffusion of cefotiam into myocardial tissue]

In 11 patients undergoing open-heart operation, 1 g of cefotiam (CTM) was administered intravenously by bolus technique at the start of operation. Samples of serum were obtained at 30, 60 and 90 minutes following administration. Samples of right atrial appendage tissue and serum were obtained simultaneously at the time of heart cannulation. Antibiotic concentrations of all samples were determined by agar well method using P. mirabilis ATCC21100 as the test organism. The results were as follows: Serum levels of CTM after 30, 60 and 90 minutes were 53.1 +/- 17.6 micrograms/ml (Mean +/- S.D., n = 10), 26.1 +/- 10.4 micrograms/ml (n = 11) and 13.5 +/- 5.5 micrograms/ml (n = 7) respectively. Myocardial tissue levels of CTM after 60 and 90 minutes were 9.4 +/- 4.7 micrograms/g (n = 4) and 4.8 +/- 2.7 micrograms/g (n = 7) respectively. The concentration ratios of the myocardial tissue to serum were 0.36 +/- 0.10 (n = 4) after 60 minutes and 0.35 +/- 0.09 (n = 7) after 90 minutes. CTM can transmigrate from blood to myocardial tissue easily as compared with other cephalosporins. Therefore, CTM, a new broad spectrum cephalosporin, can be considered as one of the highly useful antibiotics for the prevention and treatment of infections following cardiac operation.