Related Experiment Videos
Cefoxitin antibiotic concentration in bone and synovial fluid
Clinical Orthopaedics and Related Research
|August 1, 1982
Summary
Cefoxitin prophylaxis effectively achieved therapeutic antibiotic concentrations in serum, synovial fluid, and bone during joint replacement surgery. This broad-spectrum antibiotic demonstrated safety, with no allergic reactions reported in patients with prior penicillin sensitivity.
Area of Science:
- Orthopedic Surgery
- Infectious Disease
- Pharmacology
Background:
- Surgical site infections are a significant risk in total joint replacement.
- Prophylactic antibiotics are crucial for preventing infections in orthopedic procedures.
- Understanding antibiotic distribution in target tissues is vital for optimizing prophylaxis.
Purpose of the Study:
- To evaluate the pharmacokinetic profile of cefoxitin in serum, synovial fluid, and bone.
- To determine the efficacy of a single prophylactic dose of cefoxitin in total joint replacement surgery.
- To assess the safety of cefoxitin in patients with a history of penicillin allergy.
Main Methods:
- Sixty patients undergoing total hip or knee replacement received a single 2g intravenous dose of cefoxitin.
- Blood, bone, and synovial fluid samples were collected intraoperatively.
- Cefoxitin concentrations were measured using established assays.
Main Results:
- Peak serum cefoxitin concentration averaged 191 mcg/ml.
- Mean cefoxitin concentration in synovial fluid was 72 mcg/ml.
- Mean cefoxitin concentration in bone was 12 mcg/g, with simultaneous serum levels at 63 mcg/ml.
Conclusions:
- A single intravenous dose of cefoxitin achieves adequate concentrations in surgical tissues for prophylaxis in joint replacement.
- Cefoxitin is a safe prophylactic agent, even in patients with a history of penicillin allergy.
- Prophylaxis effectiveness is limited to the perioperative period; post-operative factors can still lead to infection.