THE UTILISATION OF PROPHYLACTIC CEFRIAXONE IN THORAX SURGERY AND THE DETERMINATION OF THE ANTIBIOTIC LEVEL IN LUNG TISSUE AND SERUM

In this study which was done to determine the value of prophylactic ceftriaxone in thorax surgery, 19 patients have been evaluated. 17 of the patients were operated for lung ca, 1 for cyst hidatic in lung, and 1 was operated for the carsinoid the of lung. Preop I gr IV ceftriaxone was given to the patients. During the operation serum and lung tissue samples were collected from the patients. The antibiotic level in those samples were evaluated by agar well diffusion method using Bacillus subtilis ATCC 6633 as the test organism. The antibiotic level in the tissue was measured as 12-53.6 µg/g and in serum was measured as 50.1-114.9 µg/g. This values were higher than the MIC of ceftriaxone for most of the bacteria. During postop clinical follow-up period none of the patients had wound infection or amphiema. These findings brought the conclusion that prophylactic ceftriaxone is successful and can be suggested in thorax surgery.

TORAKS CERRAHÝSÝNDE PROFÝLAKTÝK OLARAK KULLANILAN SEFTRÝAKSONUN AKCÝÐER DOKUSUNDA VE SERUMDA MÝKTAR TAYÝNÝ

Seftriaksonun toraks cerrahisindeki profilaktik deðerini belirlemek amacý ile yapýlan çalýþmada 19 hasta incelenmiþtir. Hastalarýn 17si akciðer kanseri, 1'i akciðer kist hidatik, 1 'i akciðer karsinoid Tm tanýsý ile ameliyat edilmiþtir. Hastalara ameliyat öncesi intravenöz olarak 1 gram seftriakson uygulanmýþtýr. Hastalardan ameliyat sýrasýnda alýnan kan ve akciðer dokularýndaki antibiyotik düzeyi Bacillus subtilis ATCC 6633 suþu kullanarak agarda kuyu difüzyon yöntemi uyarýnca standart eðriler ile karþýlaþtýrmak suretiyle belirlenmiþtir. Hastalarýn akciðer dokularýnda 12-53.6 µg/g, serumlarýnda 50.1-114.9 µg/ml seftriakson bulunduðu saptanmýþtýr. Elde edilen deðerler birçok bakteriye karþý saptanan seftriakson MÝK'larýdan daha yüksek bulunmuþtur. Ameliyat sonrasý hastalarýn klinik takibi sonucu hiçbirinde yara infeksiyonu ve ampiyem geliþmemiþtir. Bu bulgular toraks cerrahisinde seftriakson proflaksisinin baþarýlý olduðu ve önerebileceði sonucunu vermiþtir.