The penetration of cefazolin, erythromycin and methicillin into human bone tissue

The penetration of cefazolin, erythromycin and methicillin into normal bone was studied in 20 patients undergoing surgery for fracture in the trochanteric region of the femur. The antibiotic concentrations were determined in serum, bone marrow, and cancellous and cortical bone. For all three antibiotics the bone marrow concentrations were of the same order of magnitude as the serum concentrations. In the eight patients receiving erythromycin, detectable concentrations were found in all the cancellous bone specimens (ranging from 1/7 to 1/2 of the serum concentration) and in three cortical bone specimens (ranging from 1/50 to 1/5 of the serum concentration). In the six patients receiving cefazolin, a detectable concentration was found in only one cancellous bone sample. In the six patients receiving methicillin, detectable concentrations were found only in the blood contaminated specimens of one cancellous and two cortical bone samples. However, by the method used, the recoveries of standard solutions of methicillin in cancellous and cortical bone were about 50 per cent and 15 per cent, respectively.