Release of gentamicin from acrylic bone cement.
The pharmacokinetics of gentamicin were studied after total hip joint arthroplasties performed with "Palacos R plus gentamicin' in 10 patients. Urine was collected at 12-hour intervals for 15 days after operation, and drainage fluids for 48, 72 or 108 hours. Blood samples were taken 3 and/or 5 hours after prosthesis implantation. High concentrations of gentamicin were found in drainage fluids. Excretion curves in drainage fluids or urine were fitted by a computer-aided design program (SIAM) and the mean curves established. Elimination of gentamicin was biphasic in both cases. The rapid phases had a half-life of 2.97 hours in drainage fluids and 7.16 hours in urine. Half-lives of the slow phases were 13.5 and 47.12 hours, respectively. The mean percentage of total gentamicin released by the two routes was 5.78% of the quantity implanted. The calculated peak blood concentration was 0.12 mg/L. It is concluded that gentamicin concentrations locally reach levels higher than minimum inhibitory concentrations of most of the likely pathogens in patients undergoing total hip joint arthroplasties with "Palacos R plus gentamicin' bone cement. However, as blood concentrations appear to be low, patients may not be protected against systemic infections.
Bunetel
L
L
Laboratoire de Bactériologie, Faculté de Pharmacie, Hôpital Sud, Rennes, France.
Segui
A
A
Cormier
M
M
Percheron
E
E
Langlais
F
F
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D001843:Bone Cements / Q000592:standards; D004338:Drug Combinations; D005069:Evaluation Studies as Topic; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000493:pharmacokinetics* / Q000627:therapeutic use; D006622:Hip Prosthesis; D006801:Humans; D008297:Male; D020366:Methylmethacrylate; D008768:Methylmethacrylates / Q000494:pharmacology; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*
D001843:Bone Cements; D004338:Drug Combinations; D005839:Gentamicins; D008768:Methylmethacrylates; D020366:Methylmethacrylate