{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T07:06:50Z","timestamp":1774940810036,"version":"3.50.1"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    Surgical site infections remain significant complications after cardiac surgery and perioperative antibiotic exposure may be altered by cardiopulmonary bypass and patient characteristics. Ceftaroline fosamil is active against methicillin resistant\n                    <jats:italic>Staphylococcus aureus<\/jats:italic>\n                    (MRSA) and may be a potential alternative for patients with risk factors for MRSA. However, parasternal subcutaneous tissue exposure during cardiac surgery has not been studied. This prospective, randomized pharmacokinetic study investigated plasma and parasternal subcutaneous concentrations in patients undergoing cardiac surgery with cardiopulmonary bypass. Fourteen patients were randomized to receive a total dose of 1,800\u00a0mg of ceftaroline fosamil administered either intermittently or by continuous infusion following a loading dose. Plasma and subcutaneous tissue concentrations were measured for 24\u00a0h using arterial blood sampling and\n                    <jats:italic>in vivo<\/jats:italic>\n                    microdialysis. Pharmacokinetic parameters and pharmacodynamic target attainment were assessed for both dosing regimens. In plasma, free drug concentrations remained above the MIC of 1\u00a0mg\/L for nearly the entire dosing interval in both groups (mean\n                    <jats:italic>f<\/jats:italic>\n                    T\n                    <jats:sub>&amp;gt;MIC<\/jats:sub>\n                    \u223c99\u2013100%). Subcutaneous parasternal tissue concentrations were lower in both groups and showed marked interindividual variability. At an MIC of 1\u00a0mg\/L, mean tissue\n                    <jats:italic>f<\/jats:italic>\n                    T\n                    <jats:sub>&amp;gt;MIC<\/jats:sub>\n                    ranged from 93% to 99% with intermittent and 75%\u201386% during continuous administration. These findings demonstrate that ceftaroline penetration into subcutaneous parasternal tissue is highly variable in cardiac surgery patients and may limit tissue exposure under perioperative conditions despite favorable plasma concentrations. While continuous infusion improves plasma exposure, this does not necessarily translate into superior tissue exposure. Therefore, measurement of tissue concentrations is important when evaluating antibiotic dosing strategies in the perioperative setting.\n                  <\/jats:p>","DOI":"10.3389\/fphar.2026.1798506","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T05:34:46Z","timestamp":1774935286000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Plasma and parasternal subcutaneous tissue pharmacokinetics of ceftaroline fosamil in cardiac surgery with cardiopulmonary bypass"],"prefix":"10.3389","volume":"17","author":[{"given":"Maximilian","family":"Edlinger-Stanger","sequence":"first","affiliation":[{"name":"Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felix","family":"Bergmann","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter","family":"Jaeger","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Chemistry, University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michaela","family":"Boehmdorfer","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Chemistry, University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus","family":"Zeitlinger","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Doris","family":"Hutschala-Kinstner","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Intensive Care Medicine and Pain Medicine, Division of Cardiac Thoracic Vascular Anesthesia and Intensive Care Medicine, Medical University of Vienna","place":["Vienna, Austria"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1093\/ejcts\/ezw326","article-title":"European association for cardio-thoracic surgery expert consensus statement on the prevention and management of mediastinitis","volume":"51","author":"Abu-Omar","year":"2017","journal-title":"Eur. 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