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Diffusion of levofloxacin into bone and synovial tissues
T Rimmelé1, E Boselli, D Breilh
1Department of Anaesthesiology and Intensive Care, Hôtel-Dieu Hospital, Lyon, France.
The Journal of Antimicrobial Chemotherapy
|February 14, 2004
Summary
Levofloxacin effectively penetrates bone and synovial tissues, achieving concentrations above the susceptibility breakpoint. This antibiotic demonstrates significant therapeutic potential for bone and joint infections.
Area of Science:
- Pharmacology
- Orthopedic Surgery
- Infectious Diseases
Background:
- Antibiotic penetration to infection sites is crucial for treatment success.
- Levofloxacin is a common antibiotic for serious infections, but its penetration into bone and synovial tissues is not well-documented.
Purpose of the Study:
- To quantify the penetration of levofloxacin into bone (cortical and cancellous) and synovial tissues.
- To compare these tissue concentrations with the minimum inhibitory concentration (MIC) breakpoint for susceptible bacteria.
Main Methods:
- An open-label study involving 12 patients undergoing hip replacement surgery.
- Patients received a single 500 mg dose of levofloxacin intravenously.
- Plasma, cortical bone, cancellous bone, and synovial tissue samples were collected and analyzed using HPLC.
Main Results:
- Mean plasma levofloxacin concentration was 7.5 mg/L.
- Mean concentrations were 7.4 mg/kg in cancellous bone, 3.9 mg/kg in cortical bone, and 8.9 mg/kg in synovial tissue.
- Tissue-to-plasma concentration ratios were 1.0 for cancellous bone, 0.5 for cortical bone, and 1.2 for synovial tissue.
Conclusions:
- Levofloxacin concentrations in cancellous bone, cortical bone, and synovial tissue exceeded the susceptibility breakpoint of ≤2 mg/L.
- These findings support levofloxacin's efficacy in treating bone and joint infections.
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