Bone, subcutaneous tissue and plasma pharmacokinetics of cefuroxime in total knee replacement patients - a randomized controlled trial comparing continuous and short-term infusion.
Aged
Anti-Bacterial Agents
/ administration & dosage
Antibiotic Prophylaxis
/ methods
Arthroplasty, Replacement, Knee
Bone and Bones
/ metabolism
Cefuroxime
/ administration & dosage
Drug Administration Schedule
Humans
Infusions, Intravenous
Male
Microbial Sensitivity Tests
Microdialysis
Middle Aged
Prosthesis-Related Infections
/ prevention & control
Subcutaneous Tissue
/ metabolism
bone concentrations
cefuroxime
continuous infusion
microdialysis
population pharmacokinetics
Journal
APMIS : acta pathologica, microbiologica, et immunologica Scandinavica
ISSN: 1600-0463
Titre abrégé: APMIS
Pays: Denmark
ID NLM: 8803400
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
21
07
2019
accepted:
06
09
2019
pubmed:
14
9
2019
medline:
9
11
2019
entrez:
14
9
2019
Statut:
ppublish
Résumé
Cefuroxime is widely used as antibiotic prophylaxis for orthopaedic procedures. We evaluated bone, subcutaneous tissue (SCT) and plasma pharmacokinetics of cefuroxime in male patients undergoing total knee replacement (TKR) after both traditional short-term infusion (STI) and continuous infusion (CI). Eighteen male patients undergoing TKR were randomly assigned to STI or CI of 1.5 g of cefuroxime. Measurements were obtained in plasma, SCT, cancellous and cortical bone every 30 min for 8 h following surgery. For sampling in solid tissues, microdialysis was applied. Population pharmacokinetic modelling was performed in order to estimate pharmacokinetic parameters, and to assess the probability of attaining cefuroxime concentrations above clinically relevant minimal inhibitory concentrations (MICs) for 65% and 90% of the 8 h dosing interval. Low SCT and cortical bone penetration were found in both the STI and the CI group, but the findings were only significant in the STI group. Irrespective of MIC, tissue and target, CI leads to improved probability of attaining relevant pharmacokinetic targets compared with STI. For the Staphylococcus aureus MIC breakpoint (4 μg/mL), STI leads to inadequate probability of target attainment. CI of 1.5 g of cefuroxime leads to improved probability of attaining relevant pharmacokinetic targets in male TKR patients compared with traditional STI. These findings suggest that application of CI may improve antibiotic prophylaxis for male TKR patients.
Substances chimiques
Anti-Bacterial Agents
0
Cefuroxime
O1R9FJ93ED
Types de publication
Comparative Study
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
779-788Subventions
Organisme : The Familien Hede Nielsens Foundation
Organisme : The Scientific Foundation for Medical Doctors at Horsens Regional Hospital
Informations de copyright
© 2019 APMIS. Published by John Wiley & Sons Ltd.
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