Penetration of cefoperazone into surgical wound drainage in patients undergoing head and neck surgery

Cefoperazone penetration into skeletal muscle and wound drainage in patients undergoing major surgery of the head and neck was measured by high-pressure liquid chromatography. Cefoperazone (2 g) was infused over 30 min before surgery and every 8 h for three postoperative doses. Simultaneous samples of serum and sternomastoid muscle were collected in 18 patients at 135 to 480 min after infusion. Mean cefoperazone concentrations in muscle tissue were 17.1% of those in simultaneously collected serum. Steady-state wound drainage concentrations after the fourth dose of cefoperazone averaged 55.2 micrograms/ml at 1 to 2 h and 62.1 micrograms/ml at 2 to 3 h. Simultaneous steady-state serum and wound fluid samples were obtained at regular intervals in six patients. In all patients, the peak level in wound fluid exceeded 25 micrograms/ml. Thus, cefoperazone reaches interstitial fluid concentration in soft tissue that exceeds the MICs required to inhibit the usual pathogens found at the site of wound infection after head and neck surgery.