Treatment of osteomyelitis and septic arthritis with cefazolin.
Sixteen cases of severe osteomyelitis and septic arthritis caused by staphylococci, streptococci, gonococci, and a variety of gram-negative bacilli were treated with 4 to 8 g of parenteral cefazolin per day; nine received subsequent therapy with oral cephalexin or ampicillin. Of 16 infections, 15 were apparently cured. Cefazolin concentrations in those patients were: serum (peak), 25 to 216 micrograms/ml; synovial fluid, 24 to 46 micrograms/ml; and bone, 3.2 to 10.6 micrograms/g. Bacterial pathogens had minimal inhibitory concentrations of cefazolin of 2 micrograms or less per ml and seemed to be eradicated from foci of infection during therapy. One infection in a diabetic patient did not respond; despite high concentrations of cefazolin in serum, no detectable antibiotic was present in her infected metatarsal, and the infecting Escherichia coli (minimal inhibitory concentration, 16 micrograms/ml) was not eradicated during therapy. Concentrations of cefazolin in bone in 10 uninfected patients who received 1-g intramuscular doses prophylactically before surgery were also measured. Concentrations in bones from those who had normal renal function ranged from less than 0.6 to 2.8 micrograms/g.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001170:Arthritis, Infectious / Q000188:drug therapy*; D001842:Bone and Bones / Q000032:analysis; D002437:Cefazolin / Q000008:administration & dosage / Q000032:analysis / Q000097:blood / Q000627:therapeutic use*; D006069:Gonorrhea / Q000188:drug therapy; D006801:Humans; D008875:Middle Aged; D010019:Osteomyelitis / Q000188:drug therapy*; D013203:Staphylococcal Infections / Q000188:drug therapy; D013290:Streptococcal Infections / Q000188:drug therapy
D002437:Cefazolin
Antimicrob Agents Chemother. 1974 Nov;6(5):582-7
15825309
J Int Med Res. 1976;4(3):183-94
1026546
Ann Intern Med. 1976 Oct;85(4):461-3
970773
J Infect Dis. 1973 Oct;128:Suppl:S320-6
4200651
J Pediatr. 1974 Dec;85(6):842-7
4417819
Antimicrob Agents Chemother. 1973 Apr;3(4):488-97
4790605
Antimicrob Agents Chemother. 1976 Jan;9(1):169-71
1259390
J Infect Dis. 1973 Oct;128:Suppl:S341-6
4744015
Appl Microbiol. 1970 Apr;19(4):573-9
4986725
Ann Intern Med. 1976 Jun;84(6):661-7
820229
J Pharm Sci. 1975 Dec;64(12):1899-926
1107514
Mt Sinai J Med. 1975 Mar-Apr;42(2):142-9
1079566
Antimicrob Agents Chemother. 1976 May;9(5):852-5
949182
J Infect Dis. 1973 Oct;128:Suppl:S415-2
4744024