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[Investigation of meropenem levels in the human bone marrow blood, bone, joint fluid and joint tissues]
1Department of Orthopaedic Surgery, School of Medicine, Tohoku University.
Abstract:
A solution of 0.5 g of meropenem (MEPM) in 100 ml of saline was administered to adult patients before the orthopaedic surgery via intravenous drip infusion for 30 minutes. Eleven samples of bone marrow blood, 13 bone, 8 joint fluid and 8 joint tissues obtained from 15 clinical cases were analyzed for MEPM levels. At the same time, blood samples were taken from peripheral veins and serum served as control was analyzed. The concentration of MEPM in the marrow blood at 30 minutes after administration of MEPM reached 15.4 micrograms/ml, which was above 50% of the maximum concentration in serum. Ratios of concentration in bone marrow to that in serum were between 93% and 105% at that time. MEPM levels were 5.74-0.40 micrograms/g in bones, 20.3-4.55 micrograms/ml in joint fluid and 18.2-4.05 micrograms/g in joint tissues at 30 to 75 minutes after administration. In joint fluid and joint tissues, the concentration above 50% of maximum level in serum were maintained for more than an hour. MEPM is thought to be useful for the treatment of bone and joint infections and also prophylaxis of infections in cases of major surgery of skeletal tissue in the field of orthopaedic surgery.
Insights
Meropenem (MEPM) effectively penetrates bone and joint tissues after intravenous administration, reaching concentrations beneficial for treating orthopedic infections and prophylaxis. This study confirms its utility in orthopedic surgery settings.
Area of Science:
- Pharmacokinetics and Drug Distribution
- Orthopedic Surgery
- Infectious Disease Management
Background:
- Meropenem (MEPM) is a broad-spectrum antibiotic.
- Orthopedic surgeries carry a risk of infection.
- Understanding drug penetration into bone and joint tissues is crucial for effective treatment and prophylaxis.
Purpose of the Study:
- To evaluate the pharmacokinetic profile of meropenem (MEPM) in bone marrow, bone, joint fluid, and joint tissues.
- To determine the efficacy of MEPM for infection prophylaxis and treatment in orthopedic surgery.
Main Methods:
- Adult patients undergoing orthopedic surgery received intravenous meropenem (MEPM) infusion.
- MEPM concentrations were measured in bone marrow blood, peripheral blood serum, bone, joint fluid, and joint tissues.
- Analysis included samples taken at various time points post-administration.
Main Results:
- MEPM concentrations in bone marrow blood reached 15.4 µg/ml at 30 minutes, with marrow-to-serum concentration ratios between 93% and 105%.
- Significant MEPM levels were found in bone (5.74-0.40 µg/g), joint fluid (20.3-4.55 µg/ml), and joint tissues (18.2-4.05 µg/g) within 30-75 minutes.
- Therapeutic concentrations (>50% of maximum serum level) in joint fluid and tissues were maintained for over an hour.
Conclusions:
- Meropenem (MEPM) demonstrates excellent penetration into bone and joint tissues following intravenous administration.
- These findings support the use of MEPM for treating bone and joint infections.
- MEPM is a viable option for infection prophylaxis in major orthopedic skeletal surgery.