The Journal of Bone and Joint Surgery, Vol 76, Issue 5 689-691, Copyright © 1994 by Journal of Bone and Joint Surgery, Inc
Penetration of ceftriaxone into the intervertebral disc
R Lang, Y Folman, M Ravid, T Bental and R Gepstein
Department of Orthopaedic Surgery, Meir Hospital, Kfar Saba, Israel.
Concentrations of ceftriaxone in serum and intervertebral disc tissue were
determined with high-pressure liquid chromatography in forty-five patients
after a single intravenous loading dose of 1000 milligrams given at
different intervals before an operation on the spine. The mean serum
concentrations in this study corresponded well with reported values. The
mean tissue concentrations were 5.6 micrograms per gram (95 per cent
confidence interval, 3.6 to 6.8 micrograms per gram) one to less than two
hours after administration of the antibiotic, 6.4 micrograms per gram (95
per cent confidence interval, 2.8 to 10.0 micrograms per gram) two to less
than four hours, and 3.6 micrograms per gram (95 per cent confidence
interval, 0.6 to 6.6 micrograms per gram) at fourteen to less than sixteen
hours. These drug concentrations exceed the minimum inhibitory
concentration that was effective against 90 per cent of the bacteria for
methicillin-sensitive Staphylococcus aureus; for Streptococcus pyogenes,
agalactiae, viridans, pneumoniae, and bovis; and for community-acquired
Enterobacteriaceae. The average serum-to-tissue ratio was 191:1 at less
than one-half hour and 13:1 at less than one and a half hours. The lower
values of the 95 per cent confidence intervals for the concentration of the
antibiotic exceeded the minimum inhibitory concentrations in the disc
tissue against most susceptible bacteria during the period between one and
a half and four hours, but a larger bolus would be needed to maintain this
level for a longer period (such as in a longer operation) and as
prophylaxis against methicillin-sensitive Staphylococcus aureus and
coagulase-negative staphylococci.
CiteULike 
Connotea 
Del.icio.us 
Technorati What's this?
