Do augmentin or cefuroxime reach effective levels in lumbar vertebral discs when used prophylactically for...

The incidence of discitis following discectomy is reported at between 0.75% and 3.0%. We believe this rate could be reduced if an antibiotic that penetrated the disc tissue with an appropriate spectrum were to be given prophylactically to cover surgery. A prospective study of 20 patients undergoing routine lumbar discectomy was performed. Ten patients received Augmentin 1.2 g and ten received cefuroxime 1.5 g pre-operatively. In eight patients sequestrated disc fragments were analysed, and the majority were found to have drug levels higher than in the attached disc material; the reasons for this are discussed. We conclude that Augmentin penetrates damaged disc material to a limited extent, but cefuroxime achieves levels effective against the most commonly implicated pathogens in discitis tissue and is a rational choice of antibiotic for prophylaxis during lumbar discectomy.