Distribution of clindamycin in cortical bone during direct local infusion of the canine tibia

The distribution of clindamycin in tibial cortical bone, administered via direct local infusion with an implantable pump, is described. Clindamycin concentrations in cortical bone were measured after 3, 7, and 21 days of intraosseous infusion. The tibia were divided into four quadrants relative to the outflow infusion catheter site located in the medial aspect of the mid-diaphysis. A gradient of 5-30 mm from the infusion site was documented in all four quadrants (proximal lateral, proximal medial, distal lateral, and distal medial). At all sampling times, clindamycin concentrations in all quadrants exceeded the minimum inhibitory concentrations for gram-positive aerobic bacteria, including Staphylococcus aureus and S. epidermidis, and both the gram-positive and gram-negative anaerobes, including Peptostreptococcus species and Bacteroides species. The data suggest that gravitational forces affect the diffusion of the clindamycin because concentrations in both distal quadrants were greater than in corresponding proximal quadrants.