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Antibiotics in bone tissues. Methodological and practical aspects.

K Dornbusch

    Scandinavian Journal of Infectious Diseases. Supplementum
    |January 1, 1978
    PubMed
    Summary
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    Antibiotic levels in bone vary based on bone type and assay method. Electrophoresis revealed higher drug concentrations, suggesting reduced bone binding capacity.

    Area of Science:

    • Pharmacology
    • Orthopedic Surgery
    • Biochemistry

    Background:

    • Accurate determination of antibiotic concentrations in bone is crucial for effective orthopedic infection treatment.
    • Variability in bone antibiotic levels can be influenced by bone characteristics, drug penetration, and assay methodology.

    Purpose of the Study:

    • To measure and compare bone concentrations of doxycycline, lincomycin, clindamycin, and cefuroxime following preoperative administration.
    • To investigate the impact of different assay methods, including electrophoresis, on the determination of antibiotic levels in bone.

    Main Methods:

    • Bone samples were obtained from patients undergoing orthopedic surgery after preoperative antibiotic treatment.
    • Antibiotic concentrations were measured using the agar diffusion method after extraction.

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  • Electrophoresis in agarose-gel followed by microbiological assay was employed to re-evaluate drug levels.

    • Main Results:

    • Using the agar diffusion method, measured concentrations were: doxycycline 0.05–0.6 µg/g, clindamycin 0.4–4.9 µg/g, lincomycin 1.7–2.9 µg/g, and cefuroxime ~0.4 µg/g.
    • Electrophoresis and microbiological assay indicated higher estimated levels for these antibiotics in bone specimens.
    • The increased levels observed after electrophoresis suggest a potential decrease in the binding capacity of bone for these antibiotics.

    Conclusions:

    • Assay methodology significantly impacts the measured antibiotic levels in bone tissue.
    • Electrophoresis may enhance the estimation of antibiotic concentrations in bone by reducing drug binding.
    • These findings have implications for optimizing antibiotic dosing strategies in orthopedic surgery.