title: Bone and serum concentrations of five cephalosporin drugs. Relevance to prophylaxis and treatment in orthopedic surgery.
abstract: Bone and serum concentrations of five cephalosporins were assayed in 92 patients undergoing elective hip or knee prosthetic joint arthroplasty. One hundred twenty-five bone samples were assayed. Although there was no direct relation between serum and bone antibiotic concentrations, a trend toward increased bone antibiotic concentration for drugs with higher serum levels and longer half-lifes (cefazolin and ceforanide) was noted. Bone antibiotic concentrations were maximal within 60 minutes of drug administration. Although bone antibiotic concentrations following 2-g doses were greater than those following 1-g doses, the differences were not statistically significant. A trend toward higher bone antibiotic concentrations at hip surgery was noted, and this difference achieved statistical significance (p less than 0.05) for cefazolin. As a result of analysis of bone antibiotic concentrations, antimicrobial sensitivities, and cost, administration of 2 g of cefazolin immediately prior to operation, followed by 1 g every eight hours for 24 hours, is recommended in elective prosthetic joint surgery.
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000378:metabolism*; D002435:Cefamandole / Q000031:analogs & derivatives / Q000378:metabolism; D002437:Cefazolin / Q000378:metabolism; D002440:Cefoxitin / Q000378:metabolism; D002511:Cephalosporins / Q000097:blood / Q000378:metabolism* / Q000627:therapeutic use; D002512:Cephalothin / Q000378:metabolism; D006621:Hip Joint / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007719:Knee Joint / Q000601:surgery*; D007720:Knee Prosthesis; D008875:Middle Aged; D011292:Premedication
chemical_list: D002511:Cephalosporins; D002435:Cefamandole; D002440:Cefoxitin; C012653:ceforanide; D002437:Cefazolin; D002512:Cephalothin