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Diffusion of cefepime into cancellous and cortical bone tissue
1Pharmacokinetic and Clinical Pharmacy Department, Haut-Lévêque Hospital and Bordeaux II University, Bordeaux, France. dominique.breilh@chu-bordeaux.fr
Journal of Chemotherapy (Florence, Italy)
|June 12, 2003
Summary
Cefepime antibiotic demonstrates excellent penetration into bone tissue, achieving concentrations above inhibitory levels for common bone infection pathogens. This supports its clinical efficacy in treating bone and joint infections.
Area of Science:
- Pharmacokinetics
- Infectious Diseases
- Orthopedic Surgery
Background:
- Antibiotic penetration to infection sites is crucial for therapeutic success, especially in bone and joint infections.
- Understanding cefepime's bone tissue penetration is key to evaluating its efficacy in treating bone infections.
Purpose of the Study:
- To assess the bone tissue penetration of cefepime (2 g dose).
- To correlate cefepime bone concentrations with microbiological data for estimating clinical efficacy in bone infections.
Main Methods:
- Open-label, single-arm, noncomparative study involving patients undergoing elective total hip replacement.
- Single parenteral 2 g dose of cefepime administered.
- Plasma and bone tissue samples collected 1.5 hours post-administration and analyzed using high-performance liquid chromatography.
Main Results:
- Mean cefepime plasma concentration was 72.9 ± 24.4 µg/mL.
- Mean cefepime concentrations in cancellous bone: 73.5 ± 16.2 µg/mL; cortical bone: 67.7 ± 17.0 µg/mL.
- Bone to plasma concentration ratios (bone/plasma) were 1.06 ± 0.23 (cancellous) and 0.87 ± 0.37 (cortical).
Conclusions:
- Cefepime exhibits excellent diffusion into both cancellous and cortical bone tissue.
- Achieved bone concentrations exceed the minimum inhibitory concentration (MIC90) for many pathogens causing bone infections.
- These findings support the clinical utility of cefepime for bone infections.