Affiliation:
1. Pharmacy and Drug Information Services, Hospital of the University of Pennsylvania, Philadelphia.
Abstract
Concentrations of vancomycin in bones of 14 patients undergoing total hip arthroplasty (group 1) and 5 patients with osteomyelitis (group 2) were studied. Group 1 received vancomycin, 15 mg/kg intravenously, 1 h prior to anesthesia. Group 2 received doses adjusted to achieve peak levels in serum of 20 to 30 micrograms/ml and trough levels of less than 12 micrograms/ml; bone specimens were collected during surgical debridement. The specimens were pulverized and eluted into phosphate buffer, and the supernatants were analyzed for vancomycin content by fluorescence polarization immunoassay. In group 1, vancomycin was detectable in all cancellous specimens with a mean concentration of 2.3 +/- 4.0 micrograms/g (range, 0.5 to 16 micrograms/g); 10 of 14 cortical specimens had detectable vancomycin; the mean cortical concentration was 1.1 +/- 0.8 micrograms/g (range, not detectable to 2.6 micrograms/g). In group 2, vancomycin was detectable in only two of five cortical bone specimens (mean concentration, 5.9 +/- 3.5 micrograms/g). Cancellous bone was obtained in one patient; the vancomycin concentration was 3.6 micrograms/g. In most patients the vancomycin levels in bones were higher than the MIC for susceptible staphylococci following single prophylactic doses. In the few infected patients studied, penetration was variable and deserves further study.
Publisher
American Society for Microbiology
Subject
Infectious Diseases,Pharmacology (medical),Pharmacology
Reference16 articles.
1. In vitro experience with cefonicid;Actor P.;Rev. Infect. D)is.,1984
2. Antimicrobial susceptibility and selection of resistance among Staphylococcus epidermidis isolates recovered from patients with infections of indwelling foreign devices;Archer G. L.;Antimicrob. Agents Chemother.,1978
3. The penetration characteristics of cefazolin, cephalothin, and cephradine into bone in patients undergoing total hip replacement;Cunha B. A.;J. Bone J. Surg. Am.,1977
4. Garrod L. P. H. P. Lambert and F. O'Grady. 1981. Antibiotic and Chemotherapy 5th ed. p. 276-277. Churchill Livingstone New York.
5. Henry J. B. 1979. Clinical diagnosis and management by laboratory methods 16th ed. p. 863-868. The W. B. Saunders Co. Philadelphia.
Cited by
126 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献