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Updated: Jun 21, 2026
Treatment with Vancomycin Loaded Calcium Sulphate and Autogenous Bone in an Improved Rabbit Model of Bone Infection
Published on: March 14, 2019
Bone tissue and plasma concentrations of linezolid and vancomycin in rabbits with prosthesis-related infection due to
S Swoboda1, L Helbig, M Kommerell
1University Hospital of Heidelberg, Pharmacy Department, Im Neuenheimer Feld 670, 69120 Heidelberg, Germany. stefanie.swoboda@med.uni-heidelberg.de
Background:
Due to its safety profile and ease of oral administration, linezolid became an alternative to vancomycin in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) infections. The aim of our study was to compare bone tissue and plasma concentrations of linezolid and vancomycin in prosthesis-related MRSA infection in a rabbit model.
Material And Methods:
During implantation of titanium cylinders into the femurs of nine rabbits, a bacterial suspension of MRSA was added to induce infection. Antibiotic treatment was started eight hours later. Antibiotic concentrations in plasma (day one, three and seven) and bone (day seven) were determined by HPLC analysis.
Results:
At steady state the mean peak and trough plasma levels of linezolid were 29.0 microg/mL and 8.2 microg/ mL and for vancomycin 39.1 microg/mL and 28.2 microg/mL. On day seven the mean peak concentration of linezolid in plasma was 28.5 microg/mL and after six hours 26.3 microg/mL and for vancomycin 53.8 microg/mL and 29.1 microg/mL after six hours. Vancomycin showed a penetration into the infected bone (femur) of 53% of plasma concentration, into the uninfected 28%, linezolid 11% (for both six hours after administration).
Conclusion:
In conclusion, we observed a higher rate of tissue penetration for vancomycin than for linezolid into femur bone in this animal model. As linezolid offers the option for oral treatment of gram-positive organisms, results of further studies comparing vancomycin and linezolid are keenly awaited.
Insights
Vancomycin demonstrated superior penetration into infected bone tissue compared to linezolid in a rabbit model of MRSA bone infection. Further studies are needed to compare these antibiotics for MRSA treatment.
Area of Science:
- Pharmacology
- Infectious Diseases
- Orthopedic Surgery
Background:
- Linezolid offers an oral alternative to vancomycin for methicillin-resistant Staphylococcus aureus (MRSA) infections due to its safety and oral administration.
- Prosthesis-related infections pose a significant clinical challenge, often requiring effective antibiotic strategies.
Purpose of the Study:
- To compare bone tissue and plasma concentrations of linezolid and vancomycin.
- To evaluate antibiotic penetration in a rabbit model of prosthesis-related MRSA infection.
Main Methods:
- MRSA infection was induced in rabbit femurs with titanium cylinders.
- Antibiotic treatment with linezolid or vancomycin commenced eight hours post-infection.
- Plasma and bone antibiotic concentrations were quantified using High-Performance Liquid Chromatography (HPLC).
Main Results:
- Vancomycin achieved higher peak and trough plasma concentrations than linezolid.
- Vancomycin exhibited significantly greater penetration into infected (53%) and uninfected (28%) bone tissue compared to linezolid (11%).
Conclusions:
- Vancomycin demonstrated superior bone tissue penetration over linezolid in this MRSA bone infection rabbit model.
- While linezolid offers oral administration advantages, vancomycin's bone penetration may be critical for treating deep-seated infections.
- Further comparative studies are warranted to elucidate optimal antibiotic strategies for MRSA bone infections.
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