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Human intradiscal levels with cefazolin.

J B Boscardin1, J C Ringus, D J Feingold

  • 1Department of Orthopaedics, Palos Community Hospital, Palos Heights, Illinois.

Spine
|June 1, 1992
PubMed
Summary

Prophylactic cefazolin (antibiotic) administered intravenously reaches detectable levels in the human disc. Optimal intradiscal antibiotic concentrations are achieved 15-80 minutes after cefazolin bolus infusion.

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Area of Science:

  • Spinal Surgery
  • Pharmacology
  • Infectious Disease Prevention

Background:

  • Prophylactic antibiotics are commonly administered during spinal surgery to prevent discitis.
  • Cefazolin is a frequently used antibiotic for surgical prophylaxis.

Purpose of the Study:

  • To determine if intravenous cefazolin achieves detectable intradiscal levels.
  • To establish the optimal timing for cefazolin administration to maximize intradiscal concentrations.

Main Methods:

  • Analysis of 40 human lumbar discs obtained during surgery.
  • Intravenous administration of a 2g cefazolin bolus to all subjects.
  • Measurement of serum and intradiscal cefazolin concentrations at various time points (6-220 minutes post-infusion).

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Main Results:

  • Cefazolin was detected in intradiscal samples, confirming its diffusion into the disc.
  • A critical window of 15-80 minutes post-bolus administration was identified for achieving optimal intradiscal cefazolin levels.

Conclusions:

  • Intravenous cefazolin effectively penetrates the human disc.
  • Timing of cefazolin administration is crucial for achieving therapeutic intradiscal concentrations during spinal surgery.