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Antifungal penetration into normal rabbit nucleus pulposus
Jason M Conaughty1, Sanjay Khurana, Kresimir Banovac
1Department of Orthopedics and Rehabilitation, University of Miami School of Medicine, Miami, Florida 33101, USA. jconaugh@hotmail.com
Spine
|July 13, 2004
Summary
Fluconazole demonstrated superior penetration into the nucleus pulposus compared to amphotericin B in a rabbit model. This finding suggests fluconazole may be a better option for empiric therapy of spinal fungal infections.
Area of Science:
- Pharmacology
- Infectious Diseases
- Spine Surgery
Background:
- Spinal fungal infections often require medical management alongside other treatments.
- Limited data exists on antifungal drug penetration into the nucleus pulposus.
- Antibiotic penetration into the nucleus pulposus is well-documented, but antifungals are not.
Purpose of the Study:
- To quantify the penetration of commonly used antifungal medications into the nucleus pulposus.
- To compare the nucleus pulposus penetration of amphotericin B, amphotericin B lipid complex, and fluconazole.
Main Methods:
- A rabbit model was utilized to assess antifungal penetration.
- Twenty-four rabbits received two doses of one of three antifungal medications.
- Nucleus pulposus and serum samples were analyzed one hour post-administration using gas chromatography and bioassay.
Main Results:
- Amphotericin B and amphotericin B lipid complex showed inadequate penetration in all tested animals.
- Fluconazole achieved therapeutic tissue levels in 5 out of 7 animals.
- Three rabbits in the amphotericin B group did not survive the treatment.
Conclusions:
- Fluconazole exhibited significantly better penetration into the nucleus pulposus than amphotericin B formulations.
- These results indicate fluconazole may be a more effective choice for empirical treatment of fungal spine infections.
- Further research could validate fluconazole's role in managing spinal mycoses.