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Published on: June 23, 2020
Tissue concentrations of vancomycin and Moxifloxacin in periprosthetic infection in rats
Johannes Beckmann1, Frieder Kees, Jens Schaumburger
1Department of Orthopedic Surgery, Institute of Medical Microbiology and Hygiene, University of Regensburg, Landshut, Germany. j.beckmann@asklepios.com
Background:
A one-step exchange of an endoprosthesis with periprosthetic infection requires effective antibiotics at high concentrations around the endoprosthesis. We evaluated the tissue distribution of vancomycin and Moxifloxacin in a standardized in vivo model of periprosthetic infection.
Methods:
36 male rats with periprosthetic infection of the left hind leg, induced by a standardized procedure, received either antibiotic treatment with vancomycin or Moxifloxacin twice daily for 2 weeks, or a sham treatment. After the last administration, different tissues from each animal were evaluated for concentrations of antibiotic.
Results:
Compared to plasma, the tissue concentrations of Moxifloxacin were higher in all tissues investigated (lung, muscle, fat, bone) and the tissue-plasma ratio of Moxifloxacin was considerably higher than that of vancomycin. The concentrations of Moxifloxacin were equally high in the infected and the uninfected hind leg, whereas the vancomycin concentrations were significantly higher in the infected leg.
Interpretation:
The standardized model of periprosthetic infection described here can be extrapolated to different bacterial and mycotic pathogens, and also to different antibiotics or therapeutic regimes. It provides a way of correlating tissue concentrations with clinical outcome in future studies.
Insights
Moxifloxacin achieved higher tissue concentrations than vancomycin in a rat model of periprosthetic infection. This antibiotic distribution is crucial for effective treatment of bone infection and endoprosthesis complications.
Area of Science:
- Pharmacology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Periprosthetic infection necessitates high antibiotic concentrations at the endoprosthesis site for effective treatment.
- Evaluating antibiotic tissue distribution is critical for managing such infections.
Purpose of the Study:
- To compare the tissue distribution of vancomycin and Moxifloxacin in a rat model of periprosthetic infection.
- To assess the efficacy of these antibiotics in achieving therapeutic concentrations in infected tissues.
Main Methods:
- A standardized in vivo model of periprosthetic infection was established in 36 male rats.
- Animals received vancomycin, Moxifloxacin, or sham treatment for two weeks.
- Antibiotic concentrations in plasma and various tissues (lung, muscle, fat, bone) were measured post-treatment.
Main Results:
- Moxifloxacin demonstrated significantly higher tissue concentrations and tissue-plasma ratios compared to vancomycin across all evaluated tissues.
- Moxifloxacin concentrations remained consistent in both infected and uninfected hind legs.
- Vancomycin concentrations were notably higher in the infected hind leg compared to the uninfected leg.
Conclusions:
- The developed rat model is suitable for evaluating antibiotic efficacy and tissue distribution in periprosthetic infections.
- Findings suggest Moxifloxacin's favorable tissue penetration may offer advantages in treating periprosthetic infections.
- This model can be adapted for future studies investigating various pathogens, antibiotics, and treatment regimens to correlate tissue concentrations with clinical outcomes.
