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Bone and Serum Concentrations of Five Cephalosporin Drugs Relevance to Prophylaxis and Treatment in Orthopedic Surgery

Williams, David, N.*; Gustilo, Ramon, B.**; Beverly, RaeGene; Kind, Allan, C.*

Clinical Orthopaedics and Related Research: October 1983 - Volume 179 - Issue - p 253–265
Section III: BASIC SCIENCE AND PATHOLOGY: PDF Only
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Bone and serum concentrations of five cephalosporins were assayed in 92 patients undergoing elective hip or knee prosthetic joint arthroplasty. One hundred twenty-five bone samples were assayed. Although there was no direct relation between serum and bone antibiotic concentrations, a trend toward increased bone antibiotic concentration for drugs with higher serum levels and longer half-lifes (cefazolin and ceforanide) was noted. Bone antibiotic concentrations were maximal within 60 minutes of drug administration. Although bone antibiotic concentrations following 2-g doses were greater than those following 1-g doses, the differences were not statistically significant. A trend toward higher bone antibiotic concentrations at hip surgery was noted, and this difference achieved statistical significance (p < 0.05) for cefazolin. As a result of analysis of bone antibiotic concentrations, antimicrobial sensitivities, and cost, administration of 2 g of cefazolin immediately prior to operation, followed by 1 g every eight hours for 24 hours, is recommended in elective prosthetic joint surgery.

* Department of Medicine, St. Louis Park Medical Center, Minneapolis, Minnesota.

** Department of Orthopedic Surgery, Metropolitan Medical Center, Minneapolis, Minnesota.

Research Laboratory, St. Louis Park Medical Center, Minneapolis, Minnesota.

© Lippincott-Raven Publishers.