We conducted a prospective controlled study of thirty patients who had
an open reduction with internal fixation of a closed fracture of the femur.
Each patient received cefamandole, cefazolin, or cefoxitin intravenously
(twenty-five milligrams per kilogram of body weight) on entry into the
operating room. Intraoperatively, samples of blood, muscle, and organizing
hematoma were collected for determination of levels of the antimicrobial
agent. Throughout the operation, cefazolin was shown to result in
significantly higher levels in serum. The mean concentrations in muscle
were similar for all three drugs, but the levels in the hematoma were twice
as high with cefazolin as with cefamandole or cefoxitin. No correlation was
evident between the concentration of any of these antibiotics in the
hematoma and the interval between injury and operation.