Fleroxacin uptake in ischaemic limb tissue

Antibiotic application to patients with ischaemia of lower limbs may be indicated to avoid or treat infection of soft tissues. Fleroxacin, a fluoroquinolone, active against various Gram-negative and Gram-positive organisms may be used for this purpose. We evaluated the diffusion of fleroxacin into bone, subcutaneous fat, muscle and tendon tissues of lower limb tissue after a 400 mg i.v. dose. Concentrations in ischaemic tissues were similar to those found in non-ischaemic sites. Since the maximum antibiotic levels found were lower than the MICs of various pathogens relevant for infection, we suggest to increase the dose used for this peri-operative prophylaxis to 800 mg.