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Antibiotic penetration into cervical discs
R L Rhoten1, M A Murphy, I H Kalfas
1Department of Neurological Surgery, Cleveland Clinic Foundation, Ohio, USA.
Neurosurgery
|September 1, 1995
Summary
This study investigated antibiotic penetration into cervical discs, finding cefazolin more effective than oxacillin at higher doses. These findings inform prophylactic antibiotic use in spinal surgery to prevent infections.
Area of Science:
- Orthopedics
- Infectious Disease
- Pharmacology
Background:
- Prophylactic antibiotics are crucial in surgery to prevent infections.
- Limited data exists on antibiotic penetration into cervical discs compared to lumbar discs.
Purpose of the Study:
- To evaluate the penetration of oxacillin and cefazolin into human cervical discs.
- To determine the efficacy of different dosages of these antibiotics.
Main Methods:
- Eighteen patients undergoing discectomy had cervical discs removed.
- Antibiotic levels (oxacillin or cefazolin) were measured in discs and serum post-intravenous infusion.
- Dosages included 1g and 2g of each antibiotic.
Main Results:
- Antibiotics were detected in all removed cervical discs.
- Quantifiable levels were found in 12 discs; 9 exposed to cefazolin.
- Higher cefazolin doses (2g) showed 80% quantifiable penetration, compared to 30% for 2g oxacillin.
Conclusions:
- Cefazolin demonstrated superior penetration into cervical discs compared to oxacillin, particularly at a 2g dose.
- Findings support optimizing antibiotic selection and dosage for prophylaxis in cervical spine surgery.
- Further research is needed to establish optimal prophylactic regimens.